What is the role of angiography in the workup of vasculitis?

Updated: Dec 10, 2018
  • Author: Nadia Jennifer Chiara Luca, MD; Chief Editor: Lawrence K Jung, MD  more...
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Answer

These studies are used to assess for large and/or medium vessel vasculitis.

Angiography (CT, MR, conventional) of the aorta and its main branches is indicated when investigating for Takayasu arteritis.

  • The European Union League Against Rheumatism (EULAR) recommends MRI as a first imaging test for Takayasu arteritis and not conventional angiography. Only in cases that involve vascular intervention (eg, percutaneous transluminal balloon angioplasty or stenting) is conventional angiography recommended. [29, 30]

 

Head MR angiography is diagnostic in large/medium vessel childhood PACNS.

Vascular imaging in polyarteritis nodosa (PAN) must be done with conventional angiography because medium-sized vessels are involved (site depends on clinical features); findings include “beading” of vessels caused by alternating areas of vascular narrowing and dilatation.

Consider angiography in Behçet disease (site depends on clinical features).

CT/MR venography is indicated if venous thrombosis is suspected in antiphospholipid antibody syndrome, Behçet disease, and polyarteritis nodosa.


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