IMAGING ASSESSMENT OF INTRACRANIAL VESSELS AND BRAIN PARENCHYMA IN TAKAYASU ARTERITIS AND ITS RELATION WITH MACARONI SIGN IN CERVICAL CAROTID ARTERIES

Abstract

Objectives - Aim of this study to evaluate the imaging ndings of intracranial vascular and parenchymal involvement in Takayasu arteritis and to correlate these ndings with Macaroni sign in cervical carotid arteries. Materials and Methods: This is a cross-sectional study with total of 19 study subjects. We have evaluated each patient by ultrasonography of cervical carotid vessels. Subsequently each patient underwent MRI brain and MRA of cerebral vessels. We have assessed correlation of Macaroni sign in cervical carotid arteries with intracranial vascular and parenchymal involvement. Result: our study shows Maximum number of patients (63%) belonged to the age group (25-35) years with female predominance. Neurological involvement in the form of history of stroke were present in 31.5% of cases. In our study 19 patients of Takayasu arteritis the neck vessel involvement in the form of macaroni sign, were very common approximately 63.2% of cases. In Macaroni sign the echogenicity of intimamedia thickness were hyperechoic in most of the cases. The maximum thickness of the involved arterial wall was 2.7mm (mean ± SD, 1.14±0.66mm). Two patients of Takayasu arteritis showed calcic plaque with signicant stenosis and one patient also had the reverse ow in vertebral artery. Macaroni sign is a strong predictor for the intracranial cerebral vessels involvement in Takayasu arteritis. Conclusion: CCA involvement and Macaroni sign are very common as compared to cervical part of ICA in Takayasu arteritis. Takayasu arteritis is an unusual etiology for neurological brain parenchymal vascular insult. Ultrasonography (USG) is a simple, portable, bedside, non-invasive, standard realtime, quite sensitive and superior imaging method to detect the early changes in the wall of the arteries, progression of disease and indirect predictor of brain parenchymal vascular insult.