Type:
Educational Exhibit
Keywords:
Not applicable, Inflammation, Arteriosclerosis, Imaging sequences, Diagnostic procedure, Computer Applications-3D, MR-Angiography, MR, Vascular, Neuroradiology brain, Neuro
Authors:
V. T. Salzani1, P. N. PAIVA DE CASTRO1, E. M. Lima1, R. Queiroz Dos Santos2, D. Carvalho Machado2, L. E. Pinto2, R. Cruz Bezerra2, C. wajnberg2, P. Pitta Abreu2; 1Rio de Janeiro, Rio de Janeiro/BR, 2Rio De Janeiro/BR
DOI:
10.26044/ecr2020/C-06567
Findings and procedure details
Introduction:
Vasculitides are a heterogeneous group of diseases presenting with inflammation and necrosis of the vessel wall.
Strokes and hematic foci in multiple vascular distributions are common.
The etiological diagnosis can be corroborated by clinical and laboratorial data as well as imaging. Biopsy needs to be considered in undefined cases.
Atherosclerotic vasculopathy and cerebral vasoconstriction syndromes are the main differential diagnoses in imaging.
Etiology:
-Primary angiitis of the CNS:
- Primary systemic vasculitides: giant cell arteritis, Takayassu, polyarteritis nodosa, Kawasaki, Wegener, Churg-Strauss.
- Secondary systemic vasculitides:
- Collagen autoimmune diseases: lupus (LES), rheumatoid arthritis (RA), scleroderma.
- Infections: HSV, HIV, varicella-zoster, CMV, bacterial meningitis, tuberculosis, syphilis.
- Drugs: cocaine, amphetamine and heroine.
Differential diagnosis of vasculitides:
- Atherosclerotic vasculopathy, cerebral vasoconstriction syndromes, dissection and moyamoya are the main differential diagnoses of vasculitis when studying the vascular wall.
- Moyamoya: Stenosis or occlusion of the supraclinoid internal carotid arteries, which may extend to the anterior and middle cerebral arteries and, less frequently, to the posterior circulation.
- Dissection: Presence of luminal tapering and mural thrombus, characterized by hypersignal in dark-blood with fat suppression and without contrast.
- Atherosclerotic vasculopathy, cerebral vasoconstriction syndromes, dissection and moyamoya are the main differential diagnoses of vasculitis when studying the vascular wall.
- Moyamoya: Stenosis or occlusion of the supraclinoid internal carotid arteries, which may extend to the anterior and middle cerebral arteries and, less frequently, to the posterior circulation.
- Dissection: Presence of luminal tapering and mural thrombus, characterized by hypersignal in dark-blood with fat suppression and without contrast.