Imaging Features of Takayasu Disease

  • Lotfi Hendaoui
  • Anis Askri
  • Maya Abdallah
  • Leila Charrada-Ben Farhat
  • A. Mourad Souissi
  • Skander Mrad
  • M. Habib Bouhaouala
  • Anthony W. Stanson
Part of the Medical Radiology book series (MEDRAD)


The best diagnostic modalities of Takayasu disease are computed tomography, angiography, magnetic resonance angiography, and ultrasonography when the acoustic window is adequate. Diagnostic activity can be determinate by positron emission tomography–computed tomography scan and with a delayed-enhancement pulsed sequence by magnetic resonance angiography. The therapeutic methods are medical treatment, endovascular treatment, and surgery in the case of failure of both treatments.


Renal Artery Compute Tomography Angiography Arterial Wall Common Carotid Artery Subclavian Artery 


  1. Akazawa H, Ikeda U, Yamamoto K et al (1996a) Hypercoagulable state in patients with Takayasu’s arteritis. Thromb Haemost 75:712–716Google Scholar
  2. Akazawa H, Ikeda U, Kuroda T et al (1996b) Plasma endothelin-1 levels in Takayasu’s arteritis. Cardiology 87:303–305Google Scholar
  3. Aluquin VP, Albano SA, Chan F et al (2002) Magnetic resonance imaging in the diagnosis and follow up of Takayasu’s arteritis in children. Ann Rheum Dis 61:526–529PubMedGoogle Scholar
  4. Amano J, Suzuki A (1991) Coronary artery involvement in Takayasu’s arteritis. Collective review and guideline for surgical treatment. J Thorac Cardiovasc Surg 402:554–560Google Scholar
  5. Andrews J, Mason JC (2007) Takayasu’s arteritis-recent advances in imaging offer promise. Rheumatology 46:6–15PubMedGoogle Scholar
  6. Andrews J, Al-Nahhas A, Pennell DJ et al (2004) Non-invasive imaging in the diagnosis and management of Takayasu’s arteritis. Ann Rheum Dis 63:995–1000PubMedGoogle Scholar
  7. Arend WP, Michel BA, Bloch DA et al (1990) The American college of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 33:1129–1134PubMedGoogle Scholar
  8. Arnaud L, Haroche J, Malek Z et al (2009) Is (18)F-fluorodeoxyglucose positron emission tomography scanning a reliable way to assess disease activity in Takayasu arteritis? Arthritis Rheum 60:1193–1200PubMedGoogle Scholar
  9. Aso T, Abe S, Yaguchi T (1992) Clinical gynecologic features of pregnancy in Takayasu arteritis. Heart Vessels 7(suppl):125–132Google Scholar
  10. Ben Hassine L, Cherif E, Khalfallah N (2009) Traitement médical de la maladie de Takayasu. Rev Med Interne 30S:S262–S264Google Scholar
  11. Blétry O, Kieffer E, Herson S et al (1991) Severe pulmonary artery involvement of Takayasu arteritis. 3 cases and review of the literature. Arch Mal Coeur Vaiss 84:817–822PubMedGoogle Scholar
  12. Blétry O, Kieffer E, Thomas D (1990) L’artérite de Takayasu. STV 2:245–252Google Scholar
  13. Brack A, Martinez-Taboada V, Stanson A et al (1999) Disease pattern in cranial and large-vessel giant cell arteritis. Arthritis Rheum 42(2):311–317PubMedGoogle Scholar
  14. Chaubal N, Dighe M, Shah M (2004) Sonographic and color Doppler findings in aortoarteritis (Takayasu arteritis). J Ultrasound Med 23:937–944PubMedGoogle Scholar
  15. Chung JW, Kim H, Choi YH et al (2007) Patterns of aortic involvement in Takayasu arteritis and its clinical implications: Evaluation with spiral computed tomography angiography. J Vasc Surg 45:906–914PubMedGoogle Scholar
  16. Choe YH, Han BK, Koh EM et al (2000) Takayasu’s arteritis: assessment of disease activity with contrast-enhanced MR imaging. AJR Am J Roentgenol 175:505–511PubMedGoogle Scholar
  17. Choe YH, Kim DK, Koh EM et al (1999) Takayasu arteritis: diagnosis with MR imaging and MR angiography in acute and chronic active stages. J Magn Reson Imaging 10:751–757PubMedGoogle Scholar
  18. Dabague J, Reyes PA (1996) Takayasu’s arteritis in Mexico: a 38 year clinical perspective through literature review. Int J Cardiol 54:S103–S109PubMedGoogle Scholar
  19. Desai MY, Stone JH, Foo TK et al (2005) Delayed contrast-enhanced MRI of the aortic wall in Takayasu’s arteritis: initial experience. AJR Am J Roentgenol 184:1427–1431PubMedGoogle Scholar
  20. Derdelinckx I, Maes A, Bogaert J et al (2000) Positron emission tomography scan in the diagnosis and follow-up of aortitis of the thoracic aorta. Acta Cardiol 55:193–195PubMedGoogle Scholar
  21. Eichhorn J, Sima D, Thiele B et al (1996) Anti-endothelial cell antibodies in Takayasu arteritis. Circulation 94:2396–2401PubMedGoogle Scholar
  22. Emmerich J, Fiessinger JN (1998) Epidemiology and etiological factors in giant cell arteritis (Horton’s disease and Takayasu’s arteritis). Ann Med Intern 149:425–432Google Scholar
  23. Fiessinger JN, Tawfik-Taher S, Capron L et al (1982) Takayasu’s disease. Diagnostic criteria. Nouv Presse Med 11:583–586PubMedGoogle Scholar
  24. Frances C, Boisnic S, Bletry O et al (1990) Cutaneous manifestations of Takayasu arteritis. Dermatologica 181:266–272PubMedGoogle Scholar
  25. Gabriel SE, O’Fallon WM, Achkar AA et al (1995) The use of clinical characteristics to predict the results of temporal artery biopsy among patients with suspected giant cell arteritis. J Rheum 22:93–96PubMedGoogle Scholar
  26. Godeau P, Blétry O, Kieffet E et al (1990) Hypertension in Takayasu’s disease. Ann Med Interne 141:431–436Google Scholar
  27. Gotway MB, Araoz PA, Macedo TA et al (2005) Imaging findings in Takayasu’s arteritis. AJR Am J Roentgenol 184:1945–1950PubMedGoogle Scholar
  28. Haas A, Stiehm R (1986) Takayasu’s arteritis presenting as pulmonary hypertension. Am J Dis Child 140:372–374PubMedGoogle Scholar
  29. Hall S, Barr W, Lie JT et al (1985) Takayasu arteritis. A study of 32 North American patients. Medicine 64:89–99PubMedGoogle Scholar
  30. Hara M, Goodman PC, Leder RA (1999) FDG-PET finding in early-phase Takayasu arteritis. J Comput Assist Tomogr 23:16–18PubMedGoogle Scholar
  31. Hoffman GS, Leavitt RY, Kerr GS et al (1994) Treatment of glucocorticoid-resistant or relapsing Takayasu arteritis with methotrexate. Arthritis Rheum 37:578–582PubMedGoogle Scholar
  32. Hotchi M (1992) Pathological studies on Takayasu’s arteritis. Heart Vessels 7:11–17Google Scholar
  33. Ishikawa K (1988) Diagnostic approach and proposed criteria for the clinical diagnosis of Takayasu’s artriopathy. J Am Coll Cardiol 12:964–972PubMedGoogle Scholar
  34. Ishikawa K, Maetani S (1994) Long-term outcome for 120 Japanese patients with Takayasu’s disease. Clinical and statistical analyses of related prognostic factors. Circulation 90:1855–1860PubMedGoogle Scholar
  35. Johnston SL, Lock RJ, Gompels MM (2002) Takayasu arteritis: a review. J Clin Pathol 55:481–486PubMedGoogle Scholar
  36. Kerr GS (1995) Takayasu’s arteritis. Rheum Dis Clin North Am 21:1041–1058PubMedGoogle Scholar
  37. Kerr GS, Hallahan CW, Giordano J et al (1994) Takayasu arteritis. Ann Intern Med 120:919–929PubMedGoogle Scholar
  38. Khalilullah M, Tyagi S (1992) Percutaneous transluminal angioplasty in Takayasu arteritis. Heart Vessels Suppl 7:146–153PubMedGoogle Scholar
  39. Khandelwal N, Kalra N, Garg MK et al (2011) Multidetector CT angiography in Takayasu arteritis. Eur J Radiol 77:369–374PubMedGoogle Scholar
  40. Kinare SG (1975) Nonspecific aortitis (Takayasu’s disease). Autopsy study of 35 cases. Pathol Microbiol 43:134–139Google Scholar
  41. Kissin EY, Merkel PA (2004) Diagnostic imaging in Takayasu arteritis. Curr Opin Rheum 17:31–37Google Scholar
  42. Kobayashi Y, Ishii K, Oda K et al (2005) Aortic wall inflammation due to Takayasu arteritis imaged with 18F-FDG PET coregistered with enhanced CT. J Nucl Med 46:917–922PubMedGoogle Scholar
  43. Koide K (1992) Takayasu’s arteritis in Japan. Heart Vessels 7:48–54Google Scholar
  44. Korzets Z, Barenboim E, Berheim J et al (1998) Mesangioproliferative glomerulonephritis, antiphospholipid antibodies and Takayasu’s arteritis: is there a link? Nephrol Dial Transpl 13:991–993Google Scholar
  45. Kumar S, Radhakrishnan S, Phadke RV et al (1997) Takayasu’s arteritis: evaluation with three-dimensional time-of-flight MR angiography. Eur Radiol 7:44–50PubMedGoogle Scholar
  46. Lagneau P, Michel JB, Vuong PN (1987) Surgical treatment of Takayasu’s disease. Ann Surg 205:157–166PubMedGoogle Scholar
  47. Liang P, Tan-Ong M, Hoffman GS (2004) Takayasu’s arteritis: vascular interventions and outcomes. J Rheumatol 31:102–106PubMedGoogle Scholar
  48. Liu YQ, Jin BL, Ling J (1994) Pulmonary artery involvement in aortoarteritis: an angiographic study. Cardiovasc Intervent Radiol 17:2–6PubMedGoogle Scholar
  49. Lupi-Herrera E, Sánchez-Torres G, Marcushamer J et al (1977) Takayasu arteritis. Clinical study of 107 cases. Am Heart J 93:94–103PubMedGoogle Scholar
  50. Maeda H, Handa N, Matsumoto M et al (1991) Carotid lesions detected by B-mode ultrasonography in Takayasu’s arteritis: “macaroni sign” as an indicator of the disease. Ultrasound Med Biol 17:695–701PubMedGoogle Scholar
  51. Matsumura A, Moriwaki R, Numano F (1992) Pregnancy in Takayasu arteritis from the view of internal medicine. Heart Vessels Suppl 7:120–124PubMedGoogle Scholar
  52. Matsunaga N, Hayashi K, Sakamoto I et al (1997) Takayasu arteritis: protean radiologic manifestations and diagnosis. Radiographics 17:579–594PubMedGoogle Scholar
  53. Matsunaga N, Hayashi K, Sakamoto I et al (1998) Takayasu arteritis: MR manifestations and diagnosis of acute and chronic phase. J Magn Reson Imaging 8:406–414PubMedGoogle Scholar
  54. Meller J, Strutz F, Siefker U et al (2003) Early diagnosis and follow-up of aortitis with [(18)F]FDG PET and MRI. Eur J Nucl Med Mol Imaging 30:730–736PubMedGoogle Scholar
  55. Menanteau B, Etienne JC, Defaut P et al (1972) Takayasu’s syndrome and advanced tuberculosis. J Radiol Electrol Med Nucl 53:871–873PubMedGoogle Scholar
  56. Miyata T, Sato O, Koyama H et al (2003) Long-term survival after surgical treatment of patients with Takayasu’s arteritis. Circulation 108:1474–1480PubMedGoogle Scholar
  57. Morales E, Pineda C, Martinez-Lavin M (1991) Takayasu’s arteritis in children. J Rheumatol 18:1081–1084PubMedGoogle Scholar
  58. Moriwaki R, Noda M, Yajima M et al (1997) Clinical manifestations of Takayasu arteritis in India and Japan: new classification of angiographic findings. Angiology 48:369–379PubMedGoogle Scholar
  59. Mwipatayi BP, Jeffery PC, Beningfield SJ et al (2005) Takayasu arteritis: clinical features and management: report of 272 cases. Ann N Z J Surg 75:110–117PubMedGoogle Scholar
  60. Nakabayashi K, Kurata N, Nangi N et al (1996) Pulmonary artery involvement as first manifestation in three cases of Takayasu arteritis. Int J Cardiol 54(suppl):S177–S183PubMedGoogle Scholar
  61. Nastri MV, Baptista LPS, Baroni RH et al (2004) Gadolinium-enhanced three-dimensional MR angiography of Takayasu arteritis. Radiographics 24:773–786PubMedGoogle Scholar
  62. Neidhart B, Kosek R, Bachmann LM et al (2001) Exertional dyspnea as initial manifestation of Takayasu’s arteritis: a case report and literature review. BMC Pulm Med 1:3PubMedGoogle Scholar
  63. Nishimura S, Toubaru T, Ootaki E et al (2002) Follow-up study of aortic valve replacement surgery in patients with Takayasu’s disease complicated by aortic regurgitation. Circ J 66:564–566PubMedGoogle Scholar
  64. Numano F (2002) The story of Takayasu arteritis. Rheumatology 41:103–106PubMedGoogle Scholar
  65. Numano F, Kakuta T (1996) Takayasu arteritis: five doctors in the history of Takayasu arteritis. Int J Cardiol 54:S1–S10PubMedGoogle Scholar
  66. Numano F, Shimamoto T (1971) Hypersecretion of oestrogen in Takayasu’s disease. Am Heart J 81:591–596PubMedGoogle Scholar
  67. Park JH (1996) Conventional and CT angiographic diagnosis of Takayasu arteritis. Int J Cardiol 54(suppl):S135–S141Google Scholar
  68. Park JH, Chung JW, Lee KW et al (1997) CT angiography of Takayasu arteritis: comparison with conventional angiography. J Vasc Interv Radiol 8:393–400PubMedGoogle Scholar
  69. Park JH, Chung JW, Im JG et al (1995) Takayasu arteritis: evaluation of mural changes in the aorta and pulmonary artery with CT angiography. Radiology 196:89–93PubMedGoogle Scholar
  70. Park SH, Chung JW, Lee JW et al (2001) Carotid artery involvement in Takayasu’s arteritis: evaluation of the activity by ultrasonography. J Ultrasound Med 20:371–378PubMedGoogle Scholar
  71. Park JH, Han MC, Kim SH et al (1989) Takayasu arteritis: angiographic findings and results of angioplasty. AJR Am J Roentgenol 153:1069–1074PubMedGoogle Scholar
  72. Park JH, Hong SK, Choi KJ et al (1992) Takayasu arteritis in Korea: clinical and angiographic features. Heart Vessels 7:55–59Google Scholar
  73. Park MC, Lee SW, Park YB et al (2006) Post-interventional immunosuppressive treatment and vascular restenosis in Takayasu’s arteritis. Rheumatology 45:600–605PubMedGoogle Scholar
  74. Pascual-Lopez M, Hernandez-Nunez A, Aragues-Montanes M et al (2004) Takayasu’s disease with cutaneous involvement. Dermatology 208:10–15PubMedGoogle Scholar
  75. Paul JF, Fiessinger JN, Sapoval M et al (2001) Follow-up electron beam CT for the management of early phase Takayasu arteritis. J Comput Assist Tomogr 25:924–931PubMedGoogle Scholar
  76. Pelage JP, EL Hajjam M, Lagrange C et al (2005) Pulmonary artery interventions: an overview. Radiographics 25:1653–1667PubMedGoogle Scholar
  77. Reny JL, Paul JF, Lefebvre C et al (2003) Association of Takayasu’s arteritis and Crohn’s disease. Results of a study on 44 Takayasu patients and review of the literature. Ann Med Intern 154:85–90Google Scholar
  78. Robbs JV, Abdool-Carrim ATO, Kadwa AM (1994) Arterial reconstruction for non specific arteritis (Takayasu’s disease): medium to long term results. Eur J Vasc Surg 8:401–407PubMedGoogle Scholar
  79. Schmidt WA, Blockmans D (2005) Use of ultrasonography and positron emission tomography in the diagnosis and assessment of large-vessel vasculitis. Curr Opin Rheumatol 17:9–15PubMedGoogle Scholar
  80. Schmidt WA, Nerenheim A, Seipelt E et al (2002) Diagnosis of early Takayasu arteritis with sonography. Rheumatology 41:496–502PubMedGoogle Scholar
  81. Schonbeck U, Libby P (2004) Inflammation, immunity and HMG-CoA reductase inhibitors: statins as anti-inflammatory agents? Circulation 109:18–26Google Scholar
  82. Schuetz CT, Aeberli D, Oertle S et al (2002) Pseudoarthrosis and ankylosis of the vertebral spine without sacroiliitis associated with Takayasu’s arteritis: review of the association. Skeletal Radiol 31:554–557PubMedGoogle Scholar
  83. Seko Y, Minota S, Kawasaki A et al (1994) Perforin secreting killer cell infiltration and expression of a 65 kDa heat-shock protein in aortic tissue of patients with Takayasu’s arteritis. J Clin Invest 93:750–758PubMedGoogle Scholar
  84. Seo P, Stone JH (2004) Large-vessel vasculitis. Arthritis Rheum 15:128–139Google Scholar
  85. Seyahi E, Ugurlu S, Cumali R et al (2006) Atherosclerosis in Takayasu arteritis. Ann Rheum Dis 65:1202–1207PubMedGoogle Scholar
  86. Sharma BK, Jain S, Bali HK et al (2000) A follow-up study of balloon angioplasty and de novo stenting in Takayasu arteritis. Int J Cardiol 75(Suppl 1):S147–S152PubMedGoogle Scholar
  87. Sharma S, Gupta A (2009) Visceral artery interventions in Takayasu’s arteritis. Semin Interv Radiol 26:233–244Google Scholar
  88. Steeds RP, Mohiaddin R (2006) Takayasu arteritis: role of cardiovascular magnetic imaging. Int J Cardiol 28:1–6Google Scholar
  89. Sun Y, Yip PK, Jeng JS et al (1996) Ultrasonographic study and long-term follow-up of Takayasu’s arteritis. Stroke 27:2178–2182PubMedGoogle Scholar
  90. Suwanwela N, Piyachon C (1996) Takayasu arteritis in Thailand: clinical and imaging features. Int J Cardiol 54:S117–S134PubMedGoogle Scholar
  91. Talwar KK, Chopra P, Narula J et al (1988) Myocardial involvement and its response to immunosuppressive therapy in nonspecific aortoarteritis (Takayasu’s disease): a study by endomyocardial biopsy. Int J Cardiol 21:323–334PubMedGoogle Scholar
  92. Tatsumi M, Cohade C, Nakamoto Y et al (2003) Fluorodeoxyglucose uptake in the aortic wall at PET/CT: possible finding for active atherosclerosis. Radiology 229:831–837PubMedGoogle Scholar
  93. Tso E, Flamm SD, White RD et al (2002) Takayasu arteritis: utility and limitations of magnetic resonance imaging in diagnosis and treatment. Arthritis Rheum 46:1634–1642PubMedGoogle Scholar
  94. Tyagi S, Mehta V, Kashyap R, Kaul UA (2004) Endovascular stent implantation for severe pulmonary stenosis in aortoarteritis (Takayasu’s arteritis). Catheter Cardiovasc Interv 61:281–285PubMedGoogle Scholar
  95. Tyagi S, Verma PK, Gambhir DS, Kaul UA, Saha R, Arora R (1998) Early and long-term results of subclavian angioplasty in aortoarteritis (Takayasu disease): comparison with atherosclerosis. Cardiovasc Interv Radiol 21:219–224Google Scholar
  96. Tyagi S, Singh B, Kaul UA et al (1993) Balloon angioplasty for renovascular hypertension in Takayasu’s arteritis. Am Heart J 125(5 Pt 1):1386–1393PubMedGoogle Scholar
  97. Vanoli M, Daina E, Salvarani C et al (2005) Takayasu’s arteritis: a study of 104 Italian patients. Arthritis Rheum 53:100–107PubMedGoogle Scholar
  98. Vargas-Alarcon G, Hernandez-Pacheco G, Soto ME et al (2005) Comparative study of the residues 63 and 67 on the HLA-B molecule in patients with Takayasu’s arteritis. Immunol Lett 96:225–229PubMedGoogle Scholar
  99. Weaver FA, Yellin AE, Campen DH et al (1990) Surgical procedures in the management of Takayasu’s arteritis. J Vasc Surg 12:429–437PubMedGoogle Scholar
  100. Webb M, Chambers A, Al-Nahhas A et al (2004) The role of 18F-FDG-PET in characterizing disease activity in Takayasu’s arteritis. Eur J Nucl Med Mol Imaging 31:627–634PubMedGoogle Scholar
  101. Weiler V, Redtenbacher S, Bancher C et al (2000) Concurrence of satcoidosis and aortitis: case report and review of the literature. Ann Rheum Dis 59:850–853PubMedGoogle Scholar
  102. Weyand CM, Goronzy JJ (1995) Molecular approches toward pathologic mechanisms in giant cell arteritis and Takayasu’s arteritis. Curr Opin Rheumatol 7:30–36PubMedGoogle Scholar
  103. Yamada I, Numano F, Suzuki S (1993) Takayasu arteritis: evaluation with MR imaging. Radiology 188:89–94PubMedGoogle Scholar
  104. Yamada I, Nakagawa T, Himeno Y et al (2000) Takayasu arteritis: diagnosis with breath-hold contrast enhanced three-dimensional MR angiography. J Magn Reson Imaging 11:481–487PubMedGoogle Scholar
  105. Yamato M, Lecky JW, Hiramatsu K et al (1986) Takayasu arteritis: radiographic and angiographic findings in 59 patients. Radiology 161:329–334PubMedGoogle Scholar
  106. Yamazaki M, Takano H, Miyauchi H et al (2002) Detection of Takayasu arteritis in early stage by computed tomography. Int J Cardiol 85:305–307PubMedGoogle Scholar
  107. Yoshida S, Akiba H, Tamakawa M et al (2001) The spectrum of findings in supra-aortic Takayasu’s arteritis as seen on spiral CT angiography and digital subtraction angiography. Cardiovasc Intervent Radiol 24:117–121PubMedGoogle Scholar

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© Springer-Verlag Berlin Heidelberg  2011

Authors and Affiliations

  • Lotfi Hendaoui
    • 1
  • Anis Askri
    • 1
  • Maya Abdallah
    • 2
  • Leila Charrada-Ben Farhat
    • 1
  • A. Mourad Souissi
    • 3
  • Skander Mrad
    • 2
  • M. Habib Bouhaouala
    • 4
  • Anthony W. Stanson
    • 5
  1. 1.Department of Medical Imaging and Imaging Guided Interventions, Medical School of TunisMongi Slim University HospitalLa MarsaTunisia
  2. 2.Department of Internal Medicine, Medical School of TunisMongi Slim University HospitalLa MarsaTunisia
  3. 3.Bourran HospitalRodez Cedex 09France
  4. 4.Department of Medical Imaging, Medical School of TunisInterior Security Forces Teaching HospitalLa MarsaTunisia
  5. 5.Mayo Clinic College of MedicineMayo ClinicRochesterUSA

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