Learning objectives
To describe the principal epidemiological characteristics of Giant Cell Arteritis (GCA) and Takayasu Arteritis (TA),
their clinical presentation,
diagnostic guidelines and treatment;
To describe the Doppler ultrasound(US)technique to study the most affected vessels;
To illustrate the normal and the expected pathological findings;
To compare the advantages and limitations of DU with other diagnostic techniques.
Background
The vasculitis comprise a group of uncommon illnesses in which generalized inflammation occursin the blood vessel walls,
provoking their destruction.
They can affect arteries as well as veins.
They are divided into primary or secondary vasculitis: primary vasculitis occur in the absence of known etiological factors;secondary vasculitis occur as a consequence of a predisposing factor,
such as infection,
neoplasms,medications or other known illnesses.
The classificationof the vasculitis is controversial,
currently two classifications are being used.
Lie’s calcificationsof vasculitis (1994) and the 2012 revised international Chapel...
Findings and procedure details
The GCA is the systemic vasculitismore predominant in adults.
The blood vessels of large-medium caliber more frequently involved are the aorta,
subclavicanand iliac arteries,
with predilection for the coronary and vertebral arteries.
The GCA is also known as Temporal Arteritis,
due to its predilection for the temporal arteries,
small caliber blood vessels whichare involved in the majority of patients.
It is also known as Horton'ssyndrome,
arteritis of the aged or granulomatous arteritis.
There are various etiological factorsacknowledgeas being predisposingfactorsof GCAand a well known association with...
Conclusion
The systematic approach of the arteries with Doppler-Ultrasound in clinical suspected cases is a good imaging method to diagnose and to follow up GCA and Takayasu Arteritis.
Doppler Ultrasound allows an adequate evaluation of the wall of the more superficial arteries,
namely the temporal artery,
as well as the evaluation of the characteristics of its flow.
The halo signal in GCA and Macaroni Sign in Takayasu arteritis present high specificity and allow distinction between both arteritis.
US is not affected by the skip lesions,
like...
References
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Colour duplex sonography of temporal arteries before decision for biopsy: A prospective study in 55 patients with suspected giant cell arteritis.
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Schmidt WA,
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Vorpahl K,
Völker L,
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Color Duplex Ultrasonography in the Diagnosis of Temporal Arteritis.
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2012 Revised International Chapel Hill Consensus Conference Nomenclature of...