Which imaging studies are indicated in the workup of polyarteritis nodosa (PAN) besides angiography?

Updated: Nov 14, 2017
  • Author: Dana Jacobs-Kosmin, MD, FACP; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Turkish investigators report on the use of Doppler ultrasonography in the diagnosis of seven cases of childhood PAN. These authors recommend that Doppler ultrasound be considered in the first-line approach in the diagnosis of PAN, particularly in children. [51]

Computed tomography (CT) scanning and magnetic resonance imaging (MRI) of the GI tract may show nonspecific abnormal findings, including bowel wall thickening, mesenteric vascular engorgement, ascites, bowel obstruction, or diffuse mucosal fold thickening. For PAN with CNS involvement, new techniques, including susceptibility for blood, diffusion, and perfusion-weighted images, make MRI a very powerful modality for differentiating intracranial hemorrhage from potentially reversible ischemia (since PAN lesions are typically irreversible and progressive).

Electromyography (EMG) and nerve conduction studies (NCS) can be useful in revealing axonal nerve involvement and identifying asymmetry in nerve involvement. EMG/NCS can be used to guide a nerve biopsy, if necessary. [19, 43]


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