1、大动脉炎主讲人:郑勇副主任医师2016.4.28.定 义 a chronic, progressive, inflammatory, and obliterative disease of large vessels, with a predilection for the aorta and its major branches.Castaer E, Alguersuari A, Gallardo X, et al. When to suspect pulmonary vasculitis: radiologic and clinical clues. Radiographics. 2010
2、, 30(1):33-53.v血管壁的肉芽肿性炎vCastaer E, Alguersuari A, Gallardo X, et al. When to suspect pulmonary vasculitis: radiologic and clinical clues. Radiographics. 2010, 30(1):33-53.病理基础1996 Numano版本Takayasu分期v早期(无脉前期)v血管炎期v晚期(静态和闭塞期) v病变经常复发,导致三期混合存在 Kimura-Hayama ET, Melndez G, Mendizbal AL, et al. Uncommon
3、 congenital and acquired aortic diseases: role of multidetector CT angiography. Radiographics. 2010; 30(1):79-98.CT诊断要点v部位v动脉壁环形增厚v增强后管壁强化分为两层1.内部-低密度层-增厚的内膜2.外部-高密度层-扩张的滋养血管肺动脉受累v以狭窄为主要表现v主要累及段及亚段动脉v管壁钙化的出现MR检查v增强MRv高分辨MRMR的优势v无辐射v对比剂不引起对比剂肾病vT2WI显示内膜水肿鉴别诊断vGCAv白塞氏病1.大中小动静脉受累(主动脉+上腔静脉)2.肺动脉瘤+原位血栓形成3.滋养血管炎导致弹力层破坏,血管扩张v首选CT或MRv单纯依靠影像无法确定炎症活动vTakayasu动脉炎与GCA的关系谢 谢!