Imaging in Large Vessel Vasculitides

Background Large vessel vasculitides comprise primary vasculitides of large and medium-sized arteries with various clinical, laboratory and radiological presentations. Imaging has become increasingly important in the diagnosis and monitoring of large vessel vasculitides. It complements clinical and laboratory examination and displays vasculitic changes of large extra- and intracranial arteries with relatively good diagnostic reliability and a low level of invasiveness. Method This review presents the most important imaging modalities and some typical imaging findings in the context of the two main forms of large vessel vasculitis, giant cell arteritis and Takayasu's arteritis, with special regard to the recently launched EULAR (The European League Against Rheumatism) recommendations on the role of imaging in patients with suspected large vessel vasculitides. Results and Conclusion Color-coded duplex sonography (CCDS), magnetic resonance imaging (MRI), computed tomography (CT), and 18F-fluorodeoxyglucose positron emission tomography are today's common imaging methods in large vessel vasculitides representing a reasonable and less invasive alternative or at least a good complement to temporal artery biopsy. Today's EULAR guidelines recommend an imaging test as the first complementary method to clinical examination with CCDS as the preferred diagnostic test in suspected giant cell arteritis, MRI as the equivalent alternative in the case of inconclusive results, and MRI as the first choice in suspected Takayasu's arteritis.