CTICasesTakayasu Arteritis
Imaging findings
Contrast-enhanced chest CT shows circumferential soft-tissue thickening surrounding the aortic wall, extending from the ascending aorta through the arch and descending thoracic aorta, as well as the major arch vessels. The pulmonary arteries display multiple abnormalities including long-segment stenosis of the right main pulmonary artery and multiple peripheral segmental occlusions. Markedly dilated, hypertrophied bronchial arteries are seen serving as systemic-to-pulmonary collaterals. There is a geographic mosaic attenuation pattern in the lung parenchyma and soft-tissue thickening around abdominal branches, including the left gastric artery and celiac axis.
Key takeaways
Takayasu arteritis is a large-vessel vasculitis that primarily affects the aorta and its main branches, but also involves the pulmonary arteries in up to 50% of cases. Pulmonary artery stenosis or occlusion can lead to chronic hypoperfusion mimicking chronic thromboembolic pulmonary hypertension, with characteristic hypertrophy of bronchial collaterals. Non-compliance with immunosuppressive therapy leads to progressive, widespread arterial damage and collateralization.
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