Giant Cell Arteritis
Giant cell arteritis (GCA), also known as temporal arteritis, is a granulomatous vasculitis of medium- and large-sized arteries. GCA primarily involves the extracranial branches of the carotid artery and frequently affects the aorta and its major branches. Cranial ischemic complications, in particular permanent visual loss, constitute the most feared consequences of this disease. GCA is the most common form of systemic vasculitis in adults and preferentially occurs in the elderly. Understanding the arterial distribution of GCA is important in planning a diagnostic imaging study. For many years traditional arteriography was performed to look for the characteristic pattern and distribution of stenotic lesions that supported the diagnosis of GCA. Currently, that role has been replaced by computed tomographic angiography (CTA) and magnetic resonance angiography (MRA). Both exams are capable of producing excellent arterial displays and show increased arterial wall thickness of GCA. Diagnostic findings include segments of smooth narrowing alternating with normal caliber and increased wall thickness of the affected artery. Appearance will vary from patient to patient and with the phase of the disease process, acute or chronic. Acute disease in the arterial wall can be detected by MRA using a delayed enhancement sequence. Positron emission tomography (PET) scanning using 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) also detects acute disease. But MRA and PET images probably display different metabolic aspects of arterial inflammation. Ultrasound is an important diagnostic method for GCA. A lucent halo around the artery, wall thickening, and luminal narrowing are the diagnostic findings.
KeywordsPositron Emission Tomography Compute Tomographic Angiography Magnetic Resonance Angiography Giant Cell Arteritis Temporal Artery
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