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Table 3 MRI in inflammatory vasculitidies

From: CMR in inflammatory vasculitis

Author (Reference #)

Year published

Design

Comparison Groups

N

Role of CMR

Giant Cell Arteritis

Kornigkam-Santos [21]

2011

Retrospective

MRA in patients vs. retrospective normal controls

28

MRA detected GCA in 67% with good inter-observer agreement

Bley [25]

2005

Prospective

MRA vs. Biopsy

20

16/17 GCA + by biopsy were MRA +, all 3 GCA – were MRA -

Bley [26]

2005

Unclear

MRA in diagnosed GCA patients

21

MRA demonstrated vascular involvement in all previously diagnosed 9 patients

Walter [27]

2005

Unclear

PET in GCA

30 patients and 31 controls

PET had a sensitivity of 73.3% and specificity of 83.9%

Meller [28]

2005

Unclear

PET vs. MRA

15 FUO patients

MRA and PET had comparable sensitivity and specificity for detecting inflammation. Identical vascular territories were identified in the majority but disparate territories in a large minority

Cyran [29]

2011

Prospective

PET vs. MRI

17

Both Dynamic Contrast Enhanced MRI and PET had identical sensitivity and specificity (86 and 90% respectively) in assessing carotid and vertebral inflammation

Both [31]

2008

Prospective

PET vs. MRI

25

MRI and PET found unreliable for assessing large-vessel inflammation in GCA patients on pre-existing immunosuppressive therapy

Takayasu’s Arteritis

Li [37]

2011

Retrospective

Whole body MRI

42

Wall thickness and post-contrast intensity by MRI higher in active group than remissive group (6.12 vs. 4.31 mm and 1.56 vs. 1.17)

Desai [38]

2005

Retrospective case series

MRA-inversion recovery prepared gradient-echo MR pulse sequence

7

All patients had increased wall thickness and 5 had enhancement with contrast (4 had clinically active disease)

Choe [39]

2000

Prospective

MRI

26 patients and 16 controls

MR imaging was concordant with clinical findings in 23 patients (88.5%), with laboratory findings in most patients (ESR in 92.3% [24/26] and CRP in 84.6% [22/26])

Jiang [40]

2012

Prospective

MRA

26 patients-16 classified as active and 10 as inactive

Active group had more stenosis in left SCA than the inactive group (14/16, 87.5% vs. 2/10, 20%; p<0.01) greater vessel wall thickness in left CCA (11/16, 68.75% vs. 1/10, 10%; p<0.01) and left SCA (9/16, 56.25% vs. 0/10, 0%; p<0.01)

Tso [41]

2002

Retrospective

MRA

24

MRA revealed vessel wall edema in 94% (17 of 18), 81% (13 of 16), and 56% (24 of 43) of studies during periods of unequivocally active disease, uncertain disease activity, and apparent clinical remission, respectively. ESR and CRP did not correlate with clinical assessment or MR evidence of vascular edema

Yamada [34]

2000

Prospective

MRA vs. CA

30

Takayasu arteritis was diagnosed in 20 patients - MRA accurately revealed 323 (98%) of 330 arteries, but 7 (2%) stenotic lesions were overestimated as occluded. The sensitivity and specificity of MRA for diagnosis of Takayasu arteritis were 100%. PA lesions were demonstrated in 10 (50%) of the 20 patients.

Garg [35]

2011

Prospective

MRA vs. DSA

22

Diagnosis confirmed by MRA in all patients. MRA with sensitivity, specificity, PPV, NPV and DA for detection of a >50% lesion was 98.33%, 97.25%, 92.18%, 99.43% and 97.52% respectively.

Kawasaki Disease

Greil [54]

2007

Prospective

MRA vs. CA

6

Complete agreement between MRA and CA in detection of coronary aneurysms (n=15).Excellent agreement for aneurysm diameter, length, and distance from the ostium.

Tacke [55]

2011

Prospective

MRA vs. Echocardiography

63

MRA detected coronary aneurysms in 15 patients, whereas echo detected aneurysms in 11.

Greil [56]

2002

Prospective

MRA vs. CA

6

Excellent agreement for assessment of coronary aneurysm maximal diameter and length

Mavrogeni [57]

2004

Prospective

MRA vs. CA

13

6 patients had coronary aneurysms and 7 had ectasia. MRA and CA agreed completely for the diagnosis of aneurysms

Suzuki [58]

2006

Retrospective

MRA vs. CA

106

MRA agreed well with CA for detecting aneurysms and stenoses

Arnold [59]

2007

Prospective

MRA vs. Multidetector CT vs. CA

16

100% agreement between MDCT and CA in the detection of aneurysms and stenoses. MRI and CA had 93% agreement for the detection of aneurysms. MRI missed one stenosis.

Mavrogeni [61]

2011

Unclear

MRA in Kawasaki disease patients in convalescence

13

MRA revealed high prevalence of coronary ectasia and myocarditis in 46% (n=13) of convalescing Kawasaki disease patients

  1. Abbreviations. MRA: magnetic resonance angiography, PET: positron emission tomography, MRI: Magnetic resonance imaging, ESR: erythrocyte sedimentation rate, CRP: C-reactive protein, SCA: subclavian artery, CCA: common carotid artery, CA: conventional angiography, PPV: positive predictive value, NPV: negative predictive value, DA: diagnostic accuracy.