Objectives The aim of the study was to evaluate the feasibility of MR angiography (MRA) for evaluation of vascular inflammation in elder patients with large vessel vasculitis.
Methods 16 patients with established on PET with 18F-FDG large vessel vasculitis (14 female and 2 male; average age 66 years) were enrolled in our study. 14 patients had got giant cell arteritis (just only 3 biopsy-proven cases), 2 patients with isolated aortitis of thorax aorta and 2 cases of PMR-associated arteritis. The average duration of any disease was 8 months. All patients underwent MRA with or without contrast enhancement of aorta and its branches at 1.5 Tesla (Siemens Magnetom Essenza). All patients had repeated MRA at 6 and 12 months. All images were studied by one specialist. We evaluated the role of mural oedema as a sign of activity of vasculitis. The results of MR-angiography were compared with clinical and laboratory data, ultrasound and PET with 18F-FDG.
Results A total of 42 MRA were obtained in 16 patients. Significant mural oedema of thorax aorta or large arteries was shown by imaging in 20 of 42 cases (48.0%) and correlated with clinical and laboratory signs of vasculitis activity, progressive arterial stenosis detected by ultrasound and increased uptake of 18F-FDG on PET. 12 patients with high degree of inflammation on MRA were streroid-naïve. In 22 cases (52%), MRA had showed mild or moderate oedema of the arteries' wall. Low-moderate activity of vascular inflammation in our patients was associated with moderate or high of immunosuppressive therapy (prednisolone 40–60 mg/day). However, gradual reduction in the intensity of immunosuppression in 4 patients with mild mural oedema was associated with development of relapse of large vessel vasculitis. Notably, contrast enhancement did not improve significantly edema imaging.
Conclusions Visualisation of artery wall oedema by MRA may be a usefull approach to detect persisting inflammation in elder patients with large vessel vasculitis.
Disclosure of Interest None declared