Value of whole-body contrast-enhanced magnetic resonance angiography with vessel wall imaging in quantitative assessment of disease activity and follow-up examination in Takayasu's arteritis.

Abstract

The aim of this study is to determine the value of whole-body contrast-enhanced magnetic resonance angiography(CE-MRI) with vessel wall imaging in quantitative assessments of Takayasu's arteritis (TA) disease activity and follow-up examinations. Whole-body CE-MRI with vessel wall imaging (dark blood sequences) was performed in 52 TA patients and repeated in 15 patients after 6 months. Images were analyzed using quantitative scores. The distribution of Lupi-Herrera types (type III, 48.1 %; I, 40.4 %; II, 9.6 %; IV, 1.9 %) did not differ between active and inactive TA. Active vessel inflammation was found in seven patients diagnosed with inactive disease as Kerr scores and mainly involved the aortic arch, abdominal aorta, and ascending aorta. Quantitative MR scores were significantly higher in active TA (luminal stenosis 16.7 ± 5.3 vs. 4.2 ± 3.7, p < 0.01; wall thickening 7.2 ± 3.4 vs. 2.9 ± 2.3, p = 0.02; wall enhancement 8.7 ± 4.1 vs. 3.6 ± 2.4, p = 0.04) and positively correlated with Kerr scores, ITAS 2010, erythrocyte-sedimentation rate (ESR), and C-reactive protein (CRP) and pentraxin-3 (PTX-3) levels. At 6 months, the clinical symptoms, CRP level, and ESR improved significantly (p < 0.05) and wall enhancement decreased (6.7 ± 3.1 vs. 4.1 ± 2.1; p = 0.04), but the luminal stenosis (10.2 ± 4.3 vs. 8.8 ± 5.2; p = 0.12) and wall thickening (6.3 ± 3.8 vs. 5.8 ± 4.2; p = 0.27) remained unchanged. Whole-body CE-MRI with vessel wall imaging detected luminal changes and vessel wall inflammation in TA. Our MR scoring system enabled quantitative assessment of TA activity.