Preliminary Diagnosis: Vasculitis

I. What imaging technique is first-line for this diagnosis?

MR imaging (with and without contrast) of the area of concern. MRA (with and/or without contrast) imaging may additionally be performed.

II. Describe the advantages and disadvantages of this technique for diagnosing vasculitis.

Advantages

  • Highly sensitive and specific in detecting, detailing, and characterizing vasculitis.

  • Does not expose patients to ionizing radiation.

    Continue Reading

  • May be performed per time of flight protocol without contrast in those who cannot receive contrast.

Disadvantages

  • Expensive.

  • Time consuming.

  • May be subject to motion artifact and susceptibility weighted artifact, degrading image quality.

  • Contraindicated in patients who have non-MR compatible hardware.

III. What are the contraindications for the first-line imaging technique?

MR imaging is contraindicated in patients with non-MR compatible hardware.

IV. What alternative imaging techniques are available?

  • Contrasted CT/CTA of the area of concern.

  • Catheter angiography.

V. Describe the advantages and disadvantages of the alternative techniques for diagnosing vasculitis.

Contrasted CT/CTA of the area of concern
Advantages

  • Relatively quick imaging modality.

  • May help guide treatment and therapy.

  • Offers great detail of the surrounding soft tissues, osseous structures, and vasculature.

Disadvantages

  • Exposes patients to ionizing radiation.

  • Somewhat limited in sensitivity and specificity in characterizing the vascular structures.

Catheter angiography
Advantages

  • Gold standard for detecting, detailing, and characterizing vasculitis.

  • May help guide biopsy and treatment.

Disadvantages

  • May expose patients to large amounts of ionizing radiation.

  • Increased morbidity and mortality associated with an invasive procedure.

VI. What are the contraindications for the alternative imaging techniques?

Contrasted CT/CTA of the area of concern

  • May be contraindicated in pregnant patients, those in renal failure, and those on an inadequate dialysis regimen.

  • May be contraindicated in patients with a contrast allergy.

Catheter angiography

  • Contraindicated in those in a severe hypocoaguable state.

Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.

No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.

Jump to Section