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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.