Melanie B. Peachell, MD; Nestor L. Muller, MD, PhD

Disclosures

Semin Respir Crit Care Med. 2004;25(5) 

In This Article

Abstract and Introduction

This review summarizes the radiological manifestations of the vasculitides of proven or presumed immunologic origin in which the inflammatory reaction is directed primarily against the vessel wall. These include Wegener's granulomatosis, Churg-Strauss syndrome, Takayasu's arteritis, Behçet's syndrome, Goodpasture's syndrome, and microscopic polyangiitis. Chest radiography is used routinely in the initial evaluation and follow-up of these patients. The radiographic findings however are nonspecific and need to be interpreted together with the clinical findings. Computed tomography (CT) plays an increasingly important role in the assessment of patients with vasculitis and, in the proper clinical context, allows a confident diagnosis of some of these entities. Magnetic resonance imaging and positron emission tomography play a limited role. The characteristic imaging manifestations of the various vasculitides are reviewed and illustrated.

The pulmonary vasculitides encompass a heterogeneous group of diseases that can affect the pulmonary arteries, veins, and capillaries. They include idiopathic vasculitides, diffuse hemorrhage syndromes, secondary forms of vasculitis, and miscellaneous systemic disorders.[1]

Chest radiography and computed tomography (CT) play an important role in the initial evaluation and follow-up of patients with clinically suspected pulmonary vasculitis. This article reviews the radiological manifestations of the vasculitides of proven or presumed immunologic origin in which the inflammatory reaction is directed primarily against the vessel wall. These include Wegener's granulomatosis, Churg-Strauss syndrome, Takayasu's arteritis, Behçet's syndrome, Goodpasture's syndrome, and microscopic polyangiitis. Idiopathic vasculitis syndromes that rarely affect the lung, such as polyarteritis nodosa; cryoglobulinemic vasculitis and hypocomplementemic vasculitis; pulmonary vasculitis associated with connective tissue disease, such as lupus erythematosus; and vasculitis secondary to infection, drugs, or irradiation are beyond the scope of this review.

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