대한흉부영상의학회 Weekly Chest Cases

Case No : 378 Date 2005-01-22

Courtesy of Hyung Jun Noh, Yu Whan Oh / Anam Hospital, College of Medicine, Korea University, Korea
Age/Sex 34 / M
Chief ComplaintGeneral weakness and dyspnea for one month

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7

Diagnosis With Brief Discussion

Diagnosis: Takayasu's arteritis
Radiologic Findings
Brief Review: Takayasu’s arteritis is a chronic vasculitis mainly involving the aorta and its main branches such as the brachiocephalic, carotid, subclavian, vertebral, and renal arteries, as well as the coronary and pulmonary arteries. It induces clinically varied ischaemic symptoms due to stenotic lesions or thrombus formation. More acute progression causes destruction of the media of the arterial wall, leading to the formation of aneurysms or rupture of the involved arteries. Almost all patients have ischaemic disorders of the involved vessels (mostly cervical lesions in Japan), which present as dizziness, syncope, visual disturbance, faint or absent pulse, or differences in systolic blood pressure between arms.(1) Takayasu arteritis type IV and giant cell arteritis are vasculitic syndromes affecting the central pulmonary arterial system (large elastic and medium-sized muscular branches). They are characterized by wall thickening and stenotic changes, which can cause peripheral perfusion asymmetry and arterial thrombosis or thromboembolism with distal pulmonary infarction.(2)
References: 1. Numano F, Okawara M, Inomata H, Kobayashi Y. Takayasu’s arteritis. Lancet 2000; 356:1023-1025.
2. Engelke C, Schaefer-Prokop C, Schirg E, Freihorst J, Grubnic S, Prokop M. High-Resolution CT and CT Angiography of Peripheral Pulmonary Vascular Disorders. RadioGraphics 2002; 22: 739-764.
Keywords: Vascular, Vascular, Takayasu arteritis,

No. of Applicants : 40

▶ Correct Answer : 7/40, 17.5%

- ASL BOLOGNA Maggiore Hospital, Bologna, Italy Marcellino Burzi
- Centre d'imagerie Jacques Callot, Nancy, France Lionel Cannard
- CIM Saint Dizier, France JC Leclerc
- European Hospital, Paris, France Rached Triki
- Homs National Hospital, Homs, Syria Rami Abou Zalaf
- National Taiwan University Hospital, Taiwan Shen-Hsiang Lin
- University of Colorado School of Medicine, USA Brian Petersen

▶ Semi-Correct Answer : 4/40, 10.0%

- CHU Nancy-Brabois, France Denis Regent
- Jikei University of medicine, Japan Shigeki Misumi
- Ondokuz Mayis University, Samsun, Turkey Cetin Celenk
- Social Security Hospital, Ankara, Turkey Meric Tuzun

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 378 Date 2005-01-22

Discussion

No. of Applicants : 40