Article

Bildgebende Techniken zur Diagnostik primärer Großgefäßvaskulitiden: Teil 1: Angiographie, interventionelle Therapie und Magnetresonanztomographie

Zeitschrift für Rheumatologie (Impact Factor: 0.45). 01/2009; 68(6). DOI: 10.1007/s00393-009-0493-8

ABSTRACT Für Diagnostik und Verlaufskontrolle der Riesenzell- und der Takayasu-Arteriitis sind bildgebende Verfahren neben körperlicher Untersuchung und Laborverfahren unverzichtbar geworden. Die Wahl der jeweiligen Methode richtet sich nach der klinischen Fragestellung und der Lokalisation der zu untersuchenden Gefäßterritorien. Weiterhin sind Aspekte des Strahlenschutzes, Kontrastmittelunverträglichkeiten und andere Kontraindikationen sowie die unterschiedlichen Kosten der Verfahren zu erwägen. Dieser Übersichtsartikel stellt die klinischen und morphologischen Charakteristika der primären Großgefäßvaskulitiden dar, anhand derer die Identifikation und die Einschätzung der Krankheitsaktivität mittels Bildgebung erfolgt. Die Angiographie gilt hierbei als Goldstandard für die Diagnostik stenosierender Gefäßläsionen und beinhaltet die Option einer interventionellen Therapie. Gefäßwandverdickungen als ein entscheidendes diagnostisches Kriterium lassen sich hingegen nur mit Schnittbildverfahren erfassen. Insbesondere die MRT bietet zusätzlich zur MR-Angiographie die Option, durch Anwendung unterschiedlicher Techniken entzündliche Prozesse sowohl zentraler als auch peripherer Arterien darzustellen.

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