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1.
Rev. argent. radiol ; 84(2): 61-67, abr. 2020. tab, graf, il.
Article in Spanish | LILACS | ID: biblio-1125857

ABSTRACT

Resumen La inflamación de la aorta (aortitis) es una patología poco frecuente, con etiología infecciosa (pseudoaneurisma micótico, sífilis) y no infecciosa (arteritis, aortitis idiopática, espondilitis anquilosante, entre otras) de difícil diagnóstico clínico y variable pronóstico. Por esa razón, la utilización de diversos métodos por imágenes, tales como la tomografía computada multidetector (TCMD), la tomografía computada por emisión de positrones (PET-TC), la resonancia magnética (RM) y ultrasonido (US) facilitan la identificación, seguimiento y tratamiento de esa entidad. El siguiente trabajo tiene como objetivo realizar una revisión y actualización bibliográfica acerca de la aortitis y sus diversas etiologías, ejemplificando con casos de nuestra institución.


Abstract Aortic inflammation (aortitis) is a rare pathology, with infectious (fungal pseudoaneurysm, syphilis) and noninfectious etiology (arteritis, idiopathic aortitis, ankylosing spondylitis, among others), it has a difficult clinical diagnosis and a variable prognosis. The use of various imaging methods such as multidetector computed tomography (MDCT), magnetic resonance imaging (MRI), positron emission tomography-computed tomography (PET-CT) and ultrasound (US) facilitate the identification, monitoring and treatment of this entity. The following paper aims to perform a literature review and update about aortitis and its various etiologies, exemplifying cases of our institution.


Subject(s)
Aortitis/etiology , Aortitis/diagnostic imaging , Spondylitis, Ankylosing/diagnostic imaging , Giant Cell Arteritis/diagnostic imaging , Angiography/methods , Takayasu Arteritis/etiology , Takayasu Arteritis/diagnostic imaging , Multidetector Computed Tomography/methods
2.
Rev. chil. radiol ; 24(4): 134-141, dic. 2018. tab, ilus
Article in Spanish | LILACS | ID: biblio-978169

ABSTRACT

Resumen: La arteritis de células gigantes es una vasculitis sistémica frecuente, especialmente en mayores de 50 años. Ante la sospecha clínica el diagnóstico debe ser confirmado con histología o estudios de imágenes. La biopsia de arteria temporal se considera el gold standard, sin embargo, tiene sus limitaciones, una de ellas es la alta tasa de falsos negativos. El estudio por ecotomografía Doppler permite la visualización de las arterias temporales y en manos experimentadas puede constituir un procedimiento diagnóstico alternativo a la biopsia en el estudio inicial de esta entidad. Esta técnica es de fácil acceso, bajo costo, sin riesgos y no expone al paciente a radiación ionizante. En este trabajo revisamos la utilidad clínica de la ecotomografía Doppler en el estudio de la arteria temporal y sus hallazgos imagenológicos en la aproximación diagnóstica a la arteritis de células gigantes, siendo las características de compromiso el engrosamiento parietal arterial hipoecogénico, habitualmente concéntrico, no compresible.


Abstract: Giant cell arteritis is a frequent systemic vasculitis, especially in patients older than 50 years old. When clinically suspected, the diagnosis should be made on the basis of histology or imaging methods. Temporal artery biopsy is considered the gold standard for the diagnosis but it has some caveats, especially the existence of false negatives. Doppler ultrasound study is a low cost, accessible tool that allows visualization of temporal arteries and, in experienced hands, can replace the biopsy in the initial evaluation of the disease, without the risks of ionizing radiation. In this article we review the clinical utility of the temporal artery Doppler ultrasound and its findings in the diagnostic approach of giant cell arteritis, being characteristic a non-compressible, hypoechoic, most commonly concentric arterial wall thickening.


Subject(s)
Humans , Female , Aged , Giant Cell Arteritis/diagnostic imaging , Signs and Symptoms , Temporal Arteries/pathology , Temporal Arteries/diagnostic imaging , Giant Cell Arteritis/pathology , Giant Cell Arteritis/therapy , Ultrasonography, Doppler
3.
Rev. méd. Chile ; 146(11): 1356-1360, nov. 2018. graf
Article in Spanish | LILACS | ID: biblio-985711

ABSTRACT

Giant cell arteritis is the most common vasculitis in patients aged over 50 years. We report an 89-year-old woman with significant weight loss and persistent frontal-occipital headaches lasting two months. The neurological examination at admission identified a decrease in visual acuity of the left eye, paralysis of the third cranial nerve of the right eye and alterations of body motility without objective signs of damage of the motor or sensitive pathways. Magnetic resonance imaging showed changes of the temporal artery wall and in both vertebral arteries, as well as bilateral cerebellar and occipital ischemic lesions. The Doppler ultrasound of the temporal arteries was compatible with Giant cell arteritis. Treatment with steroids was started. While receiving oral prednisone, the patient suffered new infarcts of the posterior territory, documented with a CAT scan.


Subject(s)
Humans , Female , Aged, 80 and over , Giant Cell Arteritis/diagnostic imaging , Basilar Artery/diagnostic imaging , Vertebral Artery/diagnostic imaging , Oculomotor Nerve Diseases/diagnostic imaging , Brain Ischemia/diagnostic imaging , Oculomotor Nerve/diagnostic imaging , Temporal Arteries/diagnostic imaging , Giant Cell Arteritis/etiology , Giant Cell Arteritis/pathology , Basilar Artery/pathology , Vertebral Artery/pathology , Magnetic Resonance Imaging/methods , Oculomotor Nerve Diseases/etiology , Oculomotor Nerve Diseases/pathology , Brain Ischemia/etiology , Brain Ischemia/pathology , Ultrasonography, Doppler/methods , Oculomotor Nerve/pathology
4.
Rev. méd. Chile ; 144(11): 1486-1490, nov. 2016. ilus
Article in Spanish | LILACS | ID: biblio-845472

ABSTRACT

Large vessel vasculitis and particularly Temporal Arteritis are systemic diseases that may affect the aorta and its major branches, mainly involving extra cranial branches of the carotid artery. We report a 72-year-old man presenting with weight loss, fever and malaise. Positron emission computed tomography (PET CT) showed an extensive inflammation of the aorta and its major branches. Temporal artery biopsy confirmed the presence of vasculitis with granulomas. Treatment with a high dose of steroids had an excellent clinical response. This case underscores the utility of PET CT in the assessment of this disease.


Subject(s)
Humans , Male , Aged , Aortitis/pathology , Aortitis/diagnostic imaging , Giant Cell Arteritis/pathology , Giant Cell Arteritis/diagnostic imaging , Aortitis/drug therapy , Temporal Arteries/pathology , Giant Cell Arteritis/drug therapy , Biopsy , Positron Emission Tomography Computed Tomography
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