Bildgebung bei Großgefäßvaskulitiden

Zusammenfassung

Großgefäßvaskulitiden sind rheumatologische Autoimmunerkrankungen, die mit entzündlichen Gefäßwandveränderungen in der arteriellen Strombahn einhergehen und zu vielfältigen Organschäden führen können. Die beiden Hauptformen sind die Riesenzellarteriitis und die Takayasu-Arteriitis.

Als Bildgebungsmodalitäten stehen die Gefäßsonografie mit ihren Stärken in der unmittelbaren Point-of-care-Anwendung (insbesondere in der Riesenzellarteriitisdiagnostik), die Magnetresonanztomografie und Computertomografie mit einer besonders guten Darstellung der Aorta und ihrer Abgänge sowie die 18F-Fluordesoxyglukose-Positronenemissionstomografie (18F-FDG-PET) zur Detektion von Entzündungsherden und der Großgefäßvaskulitisdiagnostik zur Verfügung. Zukünftige Entwicklungen in der bildgebenden Diagnostik von Großgefäßvaskulitiden könnten von Verfahren profitieren, die eine zielgerichtete Darstellung der Gefäßentzündung ermöglichen, wie beispielsweise das Gallium-68 DOTAVAP-P1 PET, welches derzeit am Universitätsklinikum Bonn erforscht wird.

Abstract

Large-vessel vasculitides are rheumatologic autoimmune diseases associated with inflammatory vessel wall changes in the arterial system that can lead to severe organ damage. The two main forms are giant cell arteritis and Takayasu arteritis.

State-of-the-art imaging modalities include vascular sonography with its strength in immediate point-of-care application (especially in giant cell arteritis diagnosis), magnetic resonance imaging and computed tomography with particular emphasis on visualization of the aorta and its branches, and 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) addressing the detection of inflammatory lesions and large-vessel vasculitis. Future developments in large-vessel vasculitis imaging may benefit from techniques that allow targeted imaging of vascular inflammation, such as gallium-68 DOTAVAP-P1 PET, which is currently under investigation at the University Hospital Bonn.

Schlüsselwörter

Großgefäßvaskulitis - Riesenzellarteriitis - Takayasu-Arteriitis - Bildgebung - Gefäßsonographie - Vascular adhesion protein-1

Keywords

Large-vessel vasculitis - giant cell arteritis - Takayasu arteritis - imaging, vascular sonography - Vascular adhesion protein-1

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