Learning objectives
To list and classify the common and less common forms of aortitis.
To show representative cases of the most common forms of aortitis.
To identify the different types of aortitis on the basis of their imaging findings.
Background
Aortitis refers to inflammatory changes of the aortic wall. It is caused by infectious or more commonly noninfectious etiologies. Noninfectious aortitis occurs in vasculitis, collagen disorders, iatrogenic and idiopathic diseases. Infectious aortitis may be secondary to bacterial or viral pathogens.
The clinical features are nonspecific (pain, fever, vascular insufficiency and elevated acute phase reactants) and the prognoses is variable. However, the pattern of involvement and imaging features may help distinguish noninfectious from infectious causes.
Despite the several imaging modalities available for assessing aortitis, in the...
Findings and procedure details
Classification ofaortitis into two categories, noninfectious and infectious, is useful for clinical purposes ( Fig. 1 ).
The pattern of aortic involvement and imaging features help distinguish between noninfectious and infectious causes ( Fig. 2 ).
Takayasu arteritis (TA)
TA is a large-vessel vasculitis that predominantly affects the aorta, its major branches and the pulmonary arteries.
The initial lesions frequently occur in the left subclavian artery and progress to the other supra-aortic trunks. The abdominal aorta is involved in approximately 50% of patients.
The exact...
Conclusion
In patients admitted to ER with suspected aortitis, an enhanced CT scan allows assessing the aortic lumen, wall, surrounding tissue and other findings related to the aetiology that may help to make a rapid diagnosis and to prevent its progression.
Personal information and conflict of interest
A. J. Barrios Lopez; Madrid/ES - nothing to disclose E. Lanz Santos; Madrid/ES - nothing to disclose F. García Martínez; Madrid/ES - nothing to disclose M. Caicoya Boto; Madrid/ES - nothing to disclose A. Diez Tascón; Madrid/ES - nothing to disclose I. Pinilla Fernandez; Madrid/ES - nothing to disclose M. Martí de Gracia; Madrid/ES - nothing to disclose G. Garzón Moll; Madrid/ES - nothing to disclose D. Garrido Alonso; Madrid/ES - nothing to disclose
References
Restrepo CS, Ocazionez D, Suri R, et al. Aortitis: Imaging Spectrum of the Infectious and Inflammatory Conditions of the Aorta. RadioGraphics 2011;31:435-51.
Mamlouk MD, Aboian MS, Glastonbury CM. Erdheim-Chester disease. Radiology. 2017;284:910–917.
Lee WK, Mossop PJ, Little AF et-al. Infected (mycotic) aneurysms: spectrum of imaging appearances and management. Radiographics. 2008;28 (7): 1853-68.