What is the role of angiography in the diagnosis of polyarteritis nodosa (PAN)?

Updated: Dec 03, 2018
  • Author: Dana Jacobs-Kosmin, MD, FACP; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Angiography should be considered if clinically involved tissue is inaccessible. Conventional angiography is preferred. Computed tomography angiography or magnetic resonance angiography are not as sensitive for smaller abnormalities but can reveal larger aneurysms and stenoses. [20, 52]

Positive findings include aneurysms and stenoses of medium-sized vessels. (Note that these findings are not pathognomonic for PAN but rarely occur in MPA). [20]

Aneurysms are most commonly found in the kidney, liver, and mesenteric arteries, and their presence is associated with more severe and extensive disease.

Angiography has a higher yield in cases with evidence of intra-abdominal involvement, including clinical symptoms or signs and laboratory abnormalities of liver or renal function. Arteriograms reveal microaneurysms in the small- and medium-sized arteries of the kidneys and abdominal viscera.

For images and discussion, see Imaging in Polyarteritis Nodosa


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