Diagnóstico de la arteritis de Takayasu mediante técnicas no invasivas

Abstract

Objectives Takayasu arteritis is a chronic inflammatory obliterative disease of the great vessels that mainly affects the aorta and its primary branches. In its early phase, the clinical presentation and laboratory tests are nonspecific, so accurate diagnosis frequently depends on imaging studies. The aim of this study was to review the main features of Takayasu's arteritis and the usefulness of different noninvasive imaging techniques in the early diagnosis and follow-up of this entity. Material and methods We included 12 patients diagnosed with Takayasu's arteritis at our center. We retrospectively reviewed the different imaging studies (color Doppler US, multislice CT, and magnetic resonance) employed in each case. Results The abdominal aorta and its main branches (renal arteries, superior mesenteric artery, and celiac trunk) were involved in 8 of the 12 patients studied. This involvement was detected as increased velocities in Doppler US that were suggestive of stenosis and was later confirmed on CT angiography and MR angiography. In four patients, CT angiography and MRI angiography demonstrated diffuse and homogeneous vessel wall thickening; in two patients, these techniques also showed enhancement of the thickened walls after contrast administration that suggested active inflammatory disease. Another frequent finding was supra-aortic trunk involvement, which was seen in six cases. Conclusion Noninvasive imaging techniques are fundamental in the early diagnosis of patients with Takayasu's arteritis. CT angiography and MR angiography provide additional information about the inflammatory activity of the disease.