Takayasu Arteritis

This 15 year-old female patient with known Takayasu arteritis presented for MRI to investigate back pain. The axial T1-weighted post-gadolinium MRI above shows thickened, enhancing aortic wall, consistent with large vessel vasculitis.
Takayasu arteritis, otherwise known as idiopathic medial aortopathy, is a granulomatous vasculitis affecting the aorta and its major branches. It may also affect the pulmonary arteries. There is a strong female predominance, increased prevalence in Asian populations, and it affects younger patients (<50). The pre-pulseless phase is characterised by nonspecific systemic symptoms. The pulseless phase presents with limb ischaemia or renovascular hypertension.
Findings on imaging include wall thickening, wall enhancement, aortic stenoses, occlusion of major aortic branches, or aneurysmal dilatation of the aorta or its branches. The pulmonary arteries are commonly involved, with the most common appearance being peripheral pruning.
Treatment is with systemic steroids and judicious use of angioplasty.
Reference: Dähnert W. Radiology Review Manual 5th edition. Lippincott, Williams & Wilkins 2003
Credit: Dr Laughlin Dawes
http://www.radpod.org