Correlation of computed tomography angiography and digital subtraction angiography in nonspecific aortoarteritis (Takayasu′s arteritis)

Abstract

Background: Nonspecific aortoarteritis (NSAA) or Takayasu's arteritis is an inflammatory disorder of large elastic arteries. Imaging plays a vital role in the diagnosis and treatment of such patients. Hence, one should be aware of the imaging profile of NSAA, and the advantages and disadvantages of computed tomography angiography (CTA) and digital subtraction angiography (DSA), which are the two most commonly performed imaging investigations in these patients. Aims: The aims of this study were to evaluate the imaging profile of NSAA in a sub-group of the Indian population, and to compare the efficacy of CTA and DSA in the diagnosis of this entity. Materials and Methods: A prospective study was conducted with 25 patients, who underwent CTA and DSA for suspected NSAA in our institute between January 2009 and September 2010. The data was analyzed in terms of the demographic characteristics of the study group, most common artery involved, most common angiographic type of NSAA, and the CTA and DSA findings in the study group. Results: NSAA predominantly affects young females, as seen in this study, wherein 20 of the 25 patients were females (80%). The most common age group affected was 20-25 years. Most of the patients (44%) had involvement of more than two vessels. The most common aortic branch vessel to be involved was the renal artery. DSA was more sensitive than CTA in detecting aortic or branch vessel stenosis. However, CTA scores over DSA in the evaluation of vessel wall thickness. Conclusion: The imaging profile of NSAA in the Indian population is different from the Japanese population in that the most common branch vessel involved in the Indian population is the renal artery, as opposed to the subclavian artery in the Japanese population. CTA and DSA are both very effective in the diagnosis of NSAA. However, the best imaging modality in NSAA is DSA since it can be used for diagnosis as well as the treatment of NSAA.