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Polyarteritis Nodosa (PAN)

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Systemic Vasculitis

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

PAN is a necrotizing vasculitis affecting small and medium sized arteries in most locations in the body. It is the most common type of necrotizing vasculitis encountered at angiography and noninvasive imaging studies. Imaging findings are predominantly occlusive in nature, manifested by luminal irregularities, stenoses and occlusions, and are found in more than 90% of patients. Aneurysms, micro and macro in size, including areas of ectasia, are found in at least 60% of patients and are the most specific finding of PAN, but they may be found in other diseases such as Wegener’s granulomatosis, systemic lupus erythematosus, bacterial endocarditis and necrotizing vasculitis of drug abuse. For some patients, traditional arteriography is more effective as a diagnostic modality because it detects smaller arterial abnormalities than other imaging modalities. However, CTA and MRA have better ability to detect organ infarction and have adequate imaging capacity to identify most patients with aneurysms, especially if rupture occurs. Ultrasound may be helpful if the aneurysms are large enough to evaluate with color Doppler or if rupture has resulted in a hematoma within or adjacent to an abdominal organ. Following treatment, noninvasive imaging modalities are usually preferred to repeat angiography.

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Author information

Authors and Affiliations

  1. Diagnostic Radiology, Division of Vascular Interventional Radiology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA

    Jeremy L. Friese & Chad J. Fleming

  2. Division of Rheumatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA

    Kenneth J. Warrington & Steven R. Ytterberg

  3. Intermountain Central Laboratory—EM Laboratory, 5353 South Intermountain Drive, Murray, UT, 84157, USA

    Dylan V. Miller

  4. Emeritus of Radiology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA

    Anthony W. Stanson

Authors
  1. Jeremy L. Friese
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  2. Kenneth J. Warrington
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  3. Dylan V. Miller
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  4. Steven R. Ytterberg
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  5. Chad J. Fleming
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  6. Anthony W. Stanson
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Corresponding author

Correspondence to Jeremy L. Friese .

Editor information

Editors and Affiliations

  1. Medical School of Tunis, Department of Medical Imaging, Hôpital Mongi Slim, La Marsa, 2046, Tunisia

    Lotfi Hendaoui

  2. Mayo Graduate School of Medicine, Gonda Vascular Center, Mayo Clinic, Rochester, 55902, Minnesota, USA

    Anthony W. Stanson

  3. Medical School of Tunis, Department of Medical Imaging, Interior Security Forces Teaching Hospit, La Marsa, 2070, Tunisia

    M. Habib Bouhaouala

  4. Medical School of Toulouse University, Department of Medical Imaging, Rangueil Hospital, Toulouse CX 9, 31059, France

    Francis Joffre

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Friese, J.L., Warrington, K.J., Miller, D.V., Ytterberg, S.R., Fleming, C.J., Stanson, A.W. (2011). Polyarteritis Nodosa (PAN). In: Hendaoui, L., Stanson, A., Bouhaouala, M., Joffre, F. (eds) Systemic Vasculitis. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2011_150

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  • DOI: https://doi.org/10.1007/174_2011_150

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