title: Takayasu arteritis: intravascular contrast medium for MR angiography in the evaluation of disease activity.
abstract: OBJECTIVE
  Takayasu arteritis is difficult to diagnose, and the evaluation of disease activity is even more challenging. Laboratory, clinical, and radiologic criteria are limited indicators of disease activity. Gadofosveset trisodium is a recently introduced intravascular contrast agent. In this study we sought to investigate a correlation between clinical activity and enhancement of vascular wall thickening in patients with Takayasu arteritis who underwent MR angiography with gadofosveset.
  
  
  METHODS
  Twenty-three consecutively registered patients (21 women, two men) with Takayasu arteritis underwent MR angiography of the supraaortic trunks, aorta, and visceral vessels. Intravascular contrast medium was used to correlate thickened vessel wall enhancement with clinical criteria of disease activity. ECG-triggered black-blood first-pass high-resolution steady-state imaging was performed for all patients.
  
  
  RESULTS
  Before MR angiography, 14 patients were considered to have active disease. Heterogeneous structural involvement of the vascular tree was found. Twenty of 23 patients (87.0%) had supraaortic trunk involvement, including 12 of the 14 patients (85.7%) with active disease. Seventeen of the 23 patients (73.9%) had aortic and visceral vessel involvement, including 12 of the 14 patients (85.7%) with active disease. On steady state images in the active disease group, the mean signal-to-noise-ratio increased from 17.4 to 35.3 after gadofosveset injection (p > 0.0001), while in the nonactive disease group it increased from 52.8 to 69.6 (p = 0.08). A cutoff of 40% was best for differentiating active from inactive disease (sensitivity, 100%; specificity, 89%; positive predictive value, 92%; negative predictive value, 100%).
  
  
  CONCLUSIONS
  Use of intravascular contrast medium significantly increases the effectiveness of MR angiography in differentiating active and inactive disease.
authors.affiliation: Radiology Department, IRCCS San Raffaele Institute, Via Olgettina, 60, 20132, Milan, Italy. papa.maurizio@hsr.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Papa
authors.forename: Francesco
authors.initials: F
authors.lastname: De Cobelli
authors.forename: Elena
authors.initials: E
authors.lastname: Baldissera
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Dagna
authors.forename: Elena
authors.initials: E
authors.lastname: Schiani
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Sabbadini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Del Maschio
mesh_terms: D000328:Adult; D000368:Aged; D055424:Cardiac-Gated Imaging Techniques; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D059629:Signal-To-Noise Ratio; D013625:Takayasu Arteritis / Q000473:pathology*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D005682:Gadolinium; C109932:gadofosveset trisodium