Vasculitis - Interdisciplinary diagnostics: Radiology

Determination of disease extension and disease activity are in the foregrou nd of diagnostic imaging in vasculitides. There are several radiologic moda lities available each having specific indications. Magnetic resonance imagi ng (MRI) readily depicts granulomas and mucosal inflammations in the parana sal sinuses, nasal cavity and orbits. Computed tomography detects osseous l esions of the skull. Due to its superb sensitivity MRI is an established sc reening modality for CNS vasculitides, although there are limitations with regard to specificity. In spite of its limited accuracy in most institution s angiography is still required for radiological confirmation of CNS vascul itis. Perfusion and diffusion MR-imaging may combine the advantages of 'con ventional' MRI and angiography. By now the method is not fully validated fo r vasculitides, however. Vascular disease in Takayasu's arteritis and in gi ant cell arteritis involving predominantly large and medium sized vessels i s readily diagnosed by non invasive magnetic resonance angiography. Percuta neous transluminal angioplasty has proven to be an effective and save thera peutic modality for the cure of vascular stenoses and occlusions. Plain fil m radiography in two planes is the established modality for pulmonary imagi ng. In pulmonary vasculitides a more thorough analysis of lung disease is p rovided by high resolution computed tomography. Diagnostic imaging does sub stantially assist in the interdisciplinary management of patients suffering from vasculitides.