CTICasesTakayasu's Arteritis
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Imaging findings
A CT angiogram at an outside hospital revealed a thickened and severely narrowed left common carotid artery and extremely thickened and narrowed proximal left subclavian artery. There was extensive soft tissue thickening around both carotids and aortic wall thickening at the arch and ascending aorta. Subtle thickening was also noted at the superior mesenteric artery and lower aorta. Pulmonary arterial involvement was evident, with narrowing and soft tissue thickening of intrapulmonary right pulmonary arteries, particularly in the right lower lobe, which had a very small lumen. Hypertrophied bronchial arteries indicated a chronic process. MRA images showed edema in the aortic wall and clear perfusion defects in the right lower lobe corresponding to CT narrowing. Significant abdominal involvement was seen, including a very tight lower abdominal aorta and severely narrowed common iliac arteries, explaining the claudication.
Key takeaways
This is a nice example of Takayasu's arteritis in its acute presentation, with claudication, neurologic symptoms, and systemic fatigue. The disease involves inflammation of large arteries, with findings demonstrated on both CT and MRI.
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