Mural inflammatory hyperenhancement in MRI of giant cell (temporal) arteritis resolves under corticosteroid treatment.
OBJECTIVE
To determine the effect of corticosteroid treatment on mural inflammatory hyperenhancement in MRI in GCA.


METHODS
MRI of the superficial temporal artery with sub-millimetre in-plane spatial resolution (195 x 260 microm) was performed in 17 patients with proven GCA at the initiation of corticosteroid treatment and after 16 months of therapy. Visual MRI scores for mural inflammation were correlated with clinical and laboratory findings.


RESULTS
Intensity of inflammatory hyperenhancement decreased significantly under corticosteroid therapy (2.3 +/- 0.6 vs 0.5 +/- 0.6, P < 0.001, with MRI score >2 indicating vasculitis). This finding correlated with the clinical and serological remission in 15/17 patients. Of the two patients with active disease, one had persisting mural inflammation in MRI indicative of relapsing disease. The other patient presenting with signs of polymyalgia rheumatica had no inflammatory changes of the superficial temporal arteries on MRI scan at follow-up.


CONCLUSIONS
Mural contrast enhancement in high-resolution MRI is pronounced in active disease and decreases under corticosteroid treatment, correlating well with laboratory remission.
Bley
T A
TA
Department of Diagnostic Radiology and Medical Physics, University Hospital Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany. thorsten.bley@uniklinik-freiburg.de
Markl
M
M
Schelp
M
M
Uhl
M
M
Frydrychowicz
A
A
Vaith
P
P
Peter
H-H
HH
Langer
M
M
Warnatz
K
K
D000368:Aged; D000369:Aged, 80 and over; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002536:Cerebral Arteries / Q000473:pathology*; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D013700:Giant Cell Arteritis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007089:Image Enhancement; D007275:Injections, Intravenous; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use*; D016896:Treatment Outcome
D003287:Contrast Media; D005938:Glucocorticoids; D002097:C-Reactive Protein; D011239:Prednisolone; D019786:Gadolinium DTPA