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High-Resolution MRI in Giant Cell Arteritis: Imaging of the Wall of the Superficial Temporal Artery

Thorsten A. Bley1, Oliver Wieben2, Markus Uhl1, Jens Thiel3, Dieter Schmidt4 and Mathias Langer1

1 Department of Diagnostic Radiology, University of Freiburg, Hugstetter Strasse 55, Freiburg, BW 79106, Germany.
2 Department of Diagnostic Radiology-Medical Physics, University of Freiburg, Freiburg, Germany.
3 Department of Clinical Immunology and Rheumatology, Univesity of Freiburg, Freiburg, Germany.
4 Department of Ophthalmology, University of Freiburg, Freiburg, Germany.



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  		Fig. 1A. —Contrast-enhanced MR images of 4 patients with various degrees of mural enhancement of temporal artery (arrows). No or slight enhancement is considered physiologically normal, whereas prominent or strong mural enhancement indicates mural inflammation. Nitroglycerine capsule used as fiducial marker appears as white ball in A and C. No enhancement (73-year-old woman).

 


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  		Fig. 1B. —Contrast-enhanced MR images of 4 patients with various degrees of mural enhancement of temporal artery (arrows). No or slight enhancement is considered physiologically normal, whereas prominent or strong mural enhancement indicates mural inflammation. Nitroglycerine capsule used as fiducial marker appears as white ball in A and C. Slight enhancement (65-year-old man).

 


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  		Fig. 1C. —Contrast-enhanced MR images of 4 patients with various degrees of mural enhancement of temporal artery (arrows). No or slight enhancement is considered physiologically normal, whereas prominent or strong mural enhancement indicates mural inflammation. Nitroglycerine capsule used as fiducial marker appears as white ball in A and C. Prominent enhancement (68-year-old man).

 


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  		Fig. 1D. —Contrast-enhanced MR images of 4 patients with various degrees of mural enhancement of temporal artery (arrows). No or slight enhancement is considered physiologically normal, whereas prominent or strong mural enhancement indicates mural inflammation. Nitroglycerine capsule used as fiducial marker appears as white ball in A and C. Strong enhancement (68-year-old man).

 


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  		Fig. 2A. —MR images of 73-year-old man with giant cell arteritis. Unenhanced high-resolution coronal T1-weighted 2D spin-echo sequence (TR/TE, 500/22; field of view, 120 x 120 cm2; acquisition matrix, 384 x 512) depicts frontal branch of right temporal artery (arrow).

 


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  		Fig. 2B. —MR images of 73-year-old man with giant cell arteritis. Contrast-enhanced, fat-saturated T1-weighted 2D spin-echo sequence at same position as A shows bright contrast enhancement of thickened vessel wall, strongly indicating arteritis (arrow). Concomitant bright signal intensity of lumen of temporal vein (arrowheads) and low signal intensity of lumen of temporal artery are due to flow-void phenomenon (arrow)

 

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