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Aortic Aneurysms in Patients with Takayasu's Arteritis

CT Evaluation

¹ Department of Radiology, Omura Municipal Hospital, Kogashima-chou 133-22, Omura 856-0817, Japan.
² Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.

OBJECTIVE. The objective of this study was to evaluate the incidence, development, and outcome of aortic aneurysm on CT in a group of patients with Takayasu's arteritis.

MATERIALS AND METHODS. We reviewed the files of 31 patients with Takayasu's arteritis between January 1990 and March 1999. All patients were followed up for more than 6 months with CT, and the mean follow-up period was 52.9 months (median, 36.0 months). In all patients, initial CT was performed within 6 months of diagnosis of Takayasu's arteritis. The study group comprised 24 female patients and seven male patients; their ages at the first CT examination ranged from 8 to 72 years (mean, 42.6 ± 16.5 years).

RESULTS. Seventeen aortic aneurysms were found in 14 (45.2%) of the 31 patients. Patients with severe calcification of the aorta showed significantly lower incidence of aneurysm formation than those without severe calcification of the aorta (p < 0.05). Of the 17 aneurysms, three were not present at the time of initial CT and appeared during the follow-up period. Nine of 17 aneurysms increased in size during the follow-up period. Three of the nine aneurysms rapidly increased in size and ruptured during the follow-up period. In all three of these aneurysms, aortic wall thickening was identified on CT. The remaining six aneurysms slowly increased in size but did not rupture.

CONCLUSION. Aortic aneurysm associated with Takayasu's arteritis is not rare. The aorta with little calcification has a greater possibility of aneurysm formation in patients with Takayasu's arteritis. Aortic aneurysms with wall thickening can have fatal consequences.

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