Skip to main content

Advertisement

SpringerLink
Log in

3-T MRI reveals cranial and thoracic inflammatory changes in giant cell arteritis

  • Case Report
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Giant cell arteritis (GCA) is a diagnostic challenge. The correct diagnosis is needed for immediate initiation of corticosteroid treatment since blindness is a dreaded complication. Typically, the superficial cranial arteries are affected by this granulomatous vasculitis of large- and medium-sized arteries. However, GCA is not limited to the cranial arteries. Involvement of various arteries such as the cervical and thoracic arteries can also occur. Here, we report a case of histologically proven GCA with cranial and extracranial involvement. We illustrate the usefulness of a comprehensive vascular high-resolution magnetic resonance imaging examination that combines assessment of mural inflammatory changes of the small temporal and occipital arteries with the evaluation of extracranial vasculature to assist in the difficult non-invasive diagnosis and to determine the extent of this inflammatory disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Horton B, Magath T, Brown G (1932) An undescribed form of arteritis of the temporal vessels. Proc Staff Mtg Mayo Clin 7:700–701

    Google Scholar 

  2. Salvarani C, Cantini F, Boiardi L, Hunder GG (2002) Polymyalgia rheumatica and giant cell arteritis. N Engl J Med 347(4):261–271

    Article  PubMed  Google Scholar 

  3. Hunder GG, Bloch DA, Michel BA, Stevens MB, Arend WP, Calabrese LH et al (1990) The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum 33:1122–1128

    PubMed  CAS  Google Scholar 

  4. Schmidt WA, Kraft HE, Vorpahl K, Volker L, Gromnica-Ihle EJ (1997) Color duplex ultrasonography in the diagnosis of temporal arteritis. N Engl J Med 337(19):1336–1342

    Article  PubMed  CAS  Google Scholar 

  5. Reinhard M, Schmidt D, Hetzel A (2003) Color-coded sonography in suspected temporal arteritis—experiences after 83 cases. Rheumatol Int 24(6):340–346

    Article  PubMed  Google Scholar 

  6. Salvarani C, Silingardi M, Ghirarduzzi A et al (2002) Is duplex ultrasonography useful for the diagnosis of giant-cell arteritis? Ann Intern Med 137(4):232–238

    PubMed  Google Scholar 

  7. Karassa FB, Matsagas MI, Schmidt WA, Ioannidis JP (2005) Meta-analysis: test performance of ultrasonography for giant-cell arteritis. Ann Intern Med 142(5):359–369

    PubMed  Google Scholar 

  8. Ronthal M, Gonzalez RG, Smith RN, Frosch MP (2003) Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 21-2003. A 72-year-old man with repetitive strokes in the posterior circulation. N Engl J Med 349(2):170–180

    Article  PubMed  Google Scholar 

  9. Wilkinson IM, Russell RW (1972) Arteries of the head and neck in giant cell arteritis. A pathological study to show the pattern of arterial involvement. Arch Neurol 27(5):378–391

    PubMed  CAS  Google Scholar 

  10. de Gennes C, Le Thi Huong D, Wechsler B et al (1989) Temporal arteritis revealed by upper limb gangrene. J Rheumatol 16(1):130–132

    PubMed  Google Scholar 

  11. Lie JT, Failoni DD, Davis DC Jr (1986) Temporal arteritis with giant cell aortitis, coronary arteritis, and myocardial infarction. Arch Pathol Lab Med 110(9):857–860

    PubMed  CAS  Google Scholar 

  12. Liozon F, Weinbreck P, Vidal E et al (1986) Arterial stenoses of the arms in Horton’s temporal arteritis. Apropos of 3 cases. A review of the literature. Ann Med Interne (Paris) 137(4):307–312

    CAS  Google Scholar 

  13. Bley TA, Warnatz K, Wieben O et al (2005) High-resolution MRI in giant cell arteritis with multiple inflammatory stenoses in both calves. Rheumatology (Oxford) 44(7):954–955

    Article  CAS  Google Scholar 

  14. Helfgott SM, Bauer MR (1987) Pedal gangrene caused by giant cell arteritis. Arthritis Rheum 30(9):1078–1079

    PubMed  CAS  Google Scholar 

  15. Bley TA, Wieben O, Uhl M, Miehle N, Hennig J, Langer M, Markl M (2005) Integrated head-thoracic vascular MRI at 3 T: assessment of cranial, cervical and thoracic involvement of giant cell arteritis. MAGMA 18(4):193–200

    Article  PubMed  CAS  Google Scholar 

  16. Griswold MA, Jakob PM, Heidemann RM, Nittka M, Jellus V, Wang J, Kiefer B, Haase A (2002) Generalized autocalibrating partially parallel acquisitions (GRAPPA). Magn Reson Med 47(6):1202–1210

    Article  PubMed  Google Scholar 

  17. Norris DG (2003) High field human imaging. J Magn Reson Imaging 18(5):519–529

    Article  PubMed  Google Scholar 

  18. Trattnig S, Ba-Ssalamah A, Noebauer-Huhmann IM et al (2003) MR contrast agent at high field MRI (3 Tesla). Top Magn Reson Imaging 14(5):365–375

    Article  PubMed  Google Scholar 

  19. Bley TA, Wieben O, Uhl M, Thiel J, Schmidt D, Langer M (2005) High-resolution MRI in giant cell arteritis: imaging of the wall of the superficial temporal artery. AJR Am J Roentgenol 184(1):283–287

    PubMed  Google Scholar 

  20. Bley TA, Wieben O, Leupold J, Uhl M (2005) MRI findings in temporal arteritis. Circulation 111:e260

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The study group was supported by Das Bundesministerium für Bildung und Forschung (BMBF) grant BMBF/KNR 01 91/9949 and Deutsche Forschungsgemeinschaft (DFG) grant no. MA 2383/3-1. The authors have no conflicts of interest.

Author information

Authors and Affiliations

  1. Medical Physics Section, Department of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany

    T. A. Bley, M. Uhl, M. Langer & M. Markl

  2. Department of Clinical Immunology and Rheumatology, University Hospital Freiburg, Freiburg, Germany

    N. Venhoff & J. Thoden

Authors
  1. T. A. Bley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Uhl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. N. Venhoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Thoden
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Langer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Markl
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T. A. Bley.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bley, T.A., Uhl, M., Venhoff, N. et al. 3-T MRI reveals cranial and thoracic inflammatory changes in giant cell arteritis. Clin Rheumatol 26, 448–450 (2007). https://doi.org/10.1007/s10067-005-0160-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-005-0160-7

Keywords

Search

Navigation