title: Perfusion-based assessment of disease activity in untreated and treated patients with aortitis and chronic periaortitis: correlation with CT morphological, clinical and serological data.
abstract: OBJECTIVE
  To evaluate the role of perfusion-based assessment of inflammatory activity in patients with treated and untreated aortitis and chronic periaortitis as compared with clinical and serological markers.
  
  
  METHODS
  35 patients (20 females; median age 66 years) with (peri) aortitis were retrospectively evaluated. All patients had clinical symptoms prompting at the time of imaging. All patients first underwent whole-body contrast-enhanced CT and subsequently segmental volume perfusion CT for assessment of the degree of vascularization of (peri) aortitis as a surrogate marker for inflammatory activity. Blood flow, blood volume, volume transfer constant (k-trans), time to peak and mean transit time were determined. The thickness of the increased connective tissue formation was measured. Perfusion data were correlated with clinical symptoms and acute-phase inflammatory parameters such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leukocyte number.
  
  
  RESULTS
  21 of 35 patients were untreated and 14 of 35 had previous/ongoing immunosuppression. The interobserver agreement was good (κ = 0.78) for all perfusion parameters. Average values of perfusion parameters were higher in untreated patients but remained abnormally elevated in treated patients as well. Perfusion data and ESR and CRP correlated well both in aortitis (p < 0.05) and in periaortitis (p < 0.05). In periaortitis, perfusion parameters agreed well with ESR and CRP values (p < 0.05) only in untreated patients.
  
  
  CONCLUSIONS
  Perfusion CT parameters in untreated aortitis and chronic periaortitis correlate well with serological markers with respect to disease activity assessment. However, in treated periaortitis, correlations were weak, suggesting an increased role for (perfusion-based) imaging.
  
  
  CONCLUSIONS
  Volume perfusion CT may be used for diagnosis of aortitis/periaortitis.
authors.affiliation: 1 Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Tübingen, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Bier
authors.affiliation: 2 Department of Internal Medicine-Oncology, Eberhard Karls University, Tübingen, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Henes
authors.affiliation: 1 Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Tübingen, Germany.
authors.forename: Carolin
authors.initials: C
authors.lastname: Eulenbruch
authors.affiliation: 2 Department of Internal Medicine-Oncology, Eberhard Karls University, Tübingen, Germany.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Xenitidis
authors.affiliation: 1 Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Tübingen, Germany.
authors.forename: Konstantin
authors.initials: K
authors.lastname: Nikolaou
authors.affiliation: 1 Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Tübingen, Germany.
authors.forename: Marius
authors.initials: M
authors.lastname: Horger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001025:Aortitis / Q000097:blood* / Q000000981:diagnostic imaging*; D001027:Aortography; D054893:Cone-Beam Computed Tomography; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D015203:Reproducibility of Results; D012185:Retroperitoneal Fibrosis / Q000097:blood* / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media