E2723. Vasculitides from Head to Toe: Multimodality Imaging Diagnosis, Treatment, and Management
Authors
Anne Sailer;
Yale School of Medicine
Nadia Solomon;
Yale School of Medicine
Shin Mei Chan;
Yale School of Medicine
Irene Dixe de Oliveira Santo;
Yale School of Medicine
Angelo Marnio;
Yale School of Medicine
Maria Christina Chammas;
Hospital das Clinicas University School of Medicine
Margartia Revzin;
Yale School of Medicine
Background
Vasculitis is inflammation of blood vessel walls. The clinical and pathological features are variable and depend on the site and type of blood vessels that are affected. Vasculidities and arterial wall diseases are rare conditions of the arterial system that may result in significant complications including luminal stenosis, arterial thrombosis, and infarction of the corresponding organs and structures. As these are multisystem diseases, it is important to be aware of the imaging findings of each disease to ensure a timely diagnosis and possible treatment of the underlying vasculitis. Doppler ultrasound (US) is a first line imaging modality utilized for the assessment of the peripheral arterial system, abdominal aorta and its branches, and can be used to screen and initially diagnose and guide further multimodality imaging underlying vascular pathologies.
Educational Goals / Teaching Points
Vasculidities and arterial wall diseases are rare conditions of the arterial system that may result in significant complications including luminal stenosis, arterial thrombosis, and infarction of the corresponding organs and structures. Development of pseudoaneurysms and dissections and arterial rupture are additional serious complications in this patient population. Doppler US is a first line imaging modality utilized for the assessment of the peripheral arterial system, abdominal aorta and its branches. The exhibit includes types of arterial wall pathologies, normal arterial wall anatomy and physiology of waveforms on Doppler US, and sonographic findings associated with vasculidities and arterial wall disease with multi-imaging correlation.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Review pathophysiology of various types of vasculidities and pathologies affecting the arterial wall (collagen vascular disease, giant cell arteritis, temporal arteritis, Systemic Lupus Erythematosus (SLE), Takayasu arteritis, polyarteritis nodosa, Wegener’s granulomatosis, Kawasaki disease, and radiation-induced disease. Discuss general concepts of the assessment of the peripheral arterial system and abdominal aorta using Doppler US and CEUS: technique protocol, image optimization). Demonstrate key sonographic features of the discussed arterial pathologies with correlation other imaging modalities correlation. Review role of US is the diagnosis and surveillance of complications in this group of patients. Discuss management options with interventional radiology procedures.
Conclusion
Vasculidities are rare systemic disease affecting the arterial wall that may result in significant complications including luminal stenosis, arterial thrombosis, and infarction of the corresponding organs and structures. Timely diagnosis is essential in guiding effective treatment of the underlying vasculitis. Doppler US is a first line imaging modality utilized for the assessment of the peripheral arterial system, used to screen and initially diagnose and guide further multimodality imaging underlying vascular pathologies.
