MRA for temporal arteritis – pro
Temporal arteritis, or giant cell arteritis, is a common systemic vasculitis of unknown etiology. Ttemporal artery biopsy, a fairly easy procedure, is standard for the diagnosis of temporal arteritis. Angiography can be used when biopsy results are negative, or it can be used to help guide biopsy by demonstrating areas of abnormality. Magnetic resonance angiography (MRA) has results comparable to those of angiography in evaluating medium to large vessels. In some reported cases, MRA has successfully depicted disease in the temporal arteries. MRA can demonstrate stenoses, irregularity of the vessel wall, and beading or thickening of the vessel wall. Most of tehe vidence for usefullness of MRA is based on case reprots.
ACR assigns a score of 5/10 to MRA in the cases of “New headache in patient older than 60. Sedimentation rate higher than 55, temporal tenderness. Suspected temporal arteritis.”
Bley TA, Uhl M, Carew J, Markl M, Schmidt D, Peter HH, et al. Diagnostic value of high-resolution MR imaging in giant cell arteritis. AJNR Am J Neuroradiol. Oct 2007;28(9):1722-7. [Medline].
Khoury JA, Hoxworth JM, Mazlumzadeh M, Wellik KE, Wingerchuk DM, Demaerschalk BM. The Clinical Utility of High Resolution Magnetic Resonance Imaging in the Diagnosis of Giant Cell Arteritis: A Critically Appraised Topic. Neurologist. Sep 2008;14(5):330-335.
Jordan JE, Wippold FJ II, Cornelius RS, Amin-Hanjani S, Brunberg JA, Davis PC, De La Paz RL, Dormont D, Germano I, Gray L, Mukherji SJ, Seidenwurm DJ, Sloan MA, Turski PA, Zimmerman RD, Zipfel GJ, Expert Panel on Neurologic Imaging. ACR Appropriateness Criteria® headache. [online publication]. Reston (VA): American College of Radiology (ACR); 2009. 8 p. [51 references]