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Systemic Vasculitis pp 63–91Cite as

Giant Cell Arteritis

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Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Giant cell arteritis (GCA), also known as temporal arteritis, is a granulomatous vasculitis of medium- and large-sized arteries. GCA primarily involves the extracranial branches of the carotid artery and frequently affects the aorta and its major branches. Cranial ischemic complications, in particular permanent visual loss, constitute the most feared consequences of this disease. GCA is the most common form of systemic vasculitis in adults and preferentially occurs in the elderly. Understanding the arterial distribution of GCA is important in planning a diagnostic imaging study. For many years traditional arteriography was performed to look for the characteristic pattern and distribution of stenotic lesions that supported the diagnosis of GCA. Currently, that role has been replaced by computed tomographic angiography (CTA) and magnetic resonance angiography (MRA). Both exams are capable of producing excellent arterial displays and show increased arterial wall thickness of GCA. Diagnostic findings include segments of smooth narrowing alternating with normal caliber and increased wall thickness of the affected artery. Appearance will vary from patient to patient and with the phase of the disease process, acute or chronic. Acute disease in the arterial wall can be detected by MRA using a delayed enhancement sequence. Positron emission tomography (PET) scanning using 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) also detects acute disease. But MRA and PET images probably display different metabolic aspects of arterial inflammation. Ultrasound is an important diagnostic method for GCA. A lucent halo around the artery, wall thickening, and luminal narrowing are the diagnostic findings.

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Authors and Affiliations

  1. Division of Vascular and Interventional Radiology, Department of Radiology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA

    Chad J. Fleming & Jeremy L. Friese

  2. Division of Rheumatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA

    Kenneth J. Warrington

  3. Division of Cardiac Radiology, Department of Radiology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA

    James Glockner

  4. Intermountain Central Laboratory—EM Laboratory, 5353 South Intermountain Drive, Murray, UT, 84157, USA

    Dylan V. Miller

  5. Professor Emeritus of Radiology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA

    Anthony W. Stanson

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  1. Chad J. Fleming
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  2. Kenneth J. Warrington
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Correspondence to Chad J. Fleming .

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Editors and Affiliations

  1. Medical School of Tunis, Department of Medical Imaging, Hôpital Mongi Slim, La Marsa, 2046, Tunisia

    Lotfi Hendaoui

  2. Mayo Graduate School of Medicine, Gonda Vascular Center, Mayo Clinic, Rochester, 55902, Minnesota, USA

    Anthony W. Stanson

  3. Medical School of Tunis, Department of Medical Imaging, Interior Security Forces Teaching Hospit, La Marsa, 2070, Tunisia

    M. Habib Bouhaouala

  4. Medical School of Toulouse University, Department of Medical Imaging, Rangueil Hospital, Toulouse CX 9, 31059, France

    Francis Joffre

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Fleming, C.J., Warrington, K.J., Glockner, J., Miller, D.V., Friese, J.L., Stanson, A.W. (2011). Giant Cell Arteritis. In: Hendaoui, L., Stanson, A., Bouhaouala, M., Joffre, F. (eds) Systemic Vasculitis. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2011_147

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