TAKAYASU ARTERITIS - EVALUATION OF THE THORACIC AORTA WITH CT ANGIOGRAPHY

PURPOSE: To determine the diagnostic accuracy of computed tomographic (CT) angiography in the evaluation of Takayasu arteritis. MATERIALS AN D METHODS: Twenty-five patients with clinical symptoms suggestive of T akayasu arteritis underwent CT angiography and conventional angiograph y. Takayasu arteritis was diagnosed in 20 patients on the basis of con ventional angiography. CT angiography was performed with a helical CT scanner after injection of a bolus of contrast material, and images we re generated for three-dimensional display, multiplanar reformation, a nd maximum intensity projection. For vascular assessment, all images f rom CT angiography were used, and the results were compared with those from conventional angiography. RESULTS: CT angiography clearly depict ed various luminal changes, including stenosis, occlusion,dilatation, and aneurysm, in the thoracic aorta and its major branches. CT angiogr aphy accurately depicted 190 (95%) of 200 arteries, although the exten t of the steno-occlusive lesions was overestimated in five (2%) and un derestimated in five (2%). Furthermore, CT angiography depicted mural changes, including wall thickening, calcification, and mural thrombi, not seen with conventional angiography. The sensitivity and specificit y of CT angiography in the diagnosis of Takayasu arteritis were 95% an d 100%, respectively. CONCLUSION: Ct angiography clearly depicts both luminal and mural changes in the thoracic aorta and its major branches and has a high accuracy in the diagnosis of Takayasu arteritis.