Table Of ContentMedical Radiology
Diagnostic Imaging
Series Editors
Albert L. Baert
Maximilian F. Reiser
Hedvig Hricak
Michael Knauth
Editorial Board
Andy Adam, London
Fred Avni, Brussels
Richard L. Baron, Chicago
Carlo Bartolozzi, Pisa
George S. Bisset, Durham
A. Mark Davies, Birmingham
William P. Dillon, San Francisco
D. David Dershaw, New York
Sam Sanjiv Gambhir, Stanford
Nicolas Grenier, Bordeaux
Gertraud Heinz-Peer, Vienna
Robert Hermans, Leuven
Hans-Ulrich Kauczor, Heidelberg
Theresa McLoud, Boston
Konstantin Nikolaou, Munich
Caroline Reinhold, Montreal
Donald Resnick, San Diego
Rüdiger Schulz-Wendtland, Erlangen
Stephen Solomon, New York
Richard D. White, Columbus
For furthervolumes:
http://www.springer.com/series/4354
Lotfi Hendaoui Anthony W. Stanson
•
M. Habib Bouhaouala Francis Joffre
•
Editors
Systemic Vasculitis
Imaging Features
Foreword by
Albert L. Baert
123
Editors
Lotfi Hendaoui,MD M.Habib Bouhaouala,MD
Professor ofRadiology Professorof Radiology
Medical School ofTunis ElManar Medical Schoolof TunisEl Manar
University University
Department of Medical Imagingand Department ofMedical Imaging
Imaging GuidedInterventions InteriorSecurity ForcesTeaching Hospital
MongiSlim UniversityHospital-La Marsa 2070La Marsa
2046SidiDaoud Tunisia
Tunisia e-mail: [email protected]
e-mail: lotfi[email protected]
FrancisJoffre, MD
AnthonyW.Stanson,MD Professorof Radiology
Professor Emeritus ofRadiology Medical Schoolof ToulouseUniversity
Mayo ClinicCollege ofMedicine Department ofMedical Imaging
Mayo Clinic RangueilHospital
Rochester 55905MN ToulouseCX 9
USA France
e-mail: [email protected] e-mail: [email protected]
ISSN 0942-5373
ISBN 978-3-642-02483-2 e-ISBN978-3-642-02484-9
DOI 10.1007/978-3-642-02484-9
SpringerHeidelbergDordrechtLondonNewYork
LibraryofCongressControlNumber:2011938149
(cid:2)Springer-VerlagBerlinHeidelberg2012
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To my many colleagues, students, and mentors at Mayo Clinic with
whom I have shared my career and from whom I have learned much.
Iamespeciallygratefulforthesupportofouralliedhealthstaffwhose
dedication provided a highly professional and pleasant work
environment making our years together a joy to experience.
Above all, I dedicate this work to my wife, Carolyn, without whom my
achievements and joy would be incomplete.
….AWS
To our mentors withwhom westarted our career (especially JChalut,
JC Gaux, JP Monnier, J Chermet and JM Tubiana) and to our many
colleagues and fellows from whom we have learned much. We are
also indebted to our allied health staff for their unfailing support.
….LH, FJ and MHB
To Ismaïl, my son and Inès, my daughter, who through the years, have
made me so proud to be their father.
Above all, I dedicate this work to my beloved wife, Reine with my
gratitude for her extraordinary patience and understanding.
….LH
ToBalkiss,mywifeandMehdi,FatmaandSanamychildren,fortheir
patience and constant support.
…MHB
September 2011
Foreword
Radiological imaging can contribute substantially to an exact and early diag-
nosis of systemic vasculitis, an uncommon condition which requires rapid
appropriate treatment.
This volume of Medical Radiology deals comprehensively with the modern
imaging modalities needed to detect vasculitis and provides a wealth of infor-
mationtoanyonedealingwiththesepatients.Theeditorshaveshownaspecific,
extensive and longstanding interest in the field of inflammation of walls of the
bloodvesselsasdemonstratedbytheirpreviousscientificpublicationsandshare
their exceptional clinical expertise with the readers in this superbly illustrated
volume.Itiscompletedbyasectiononautoevaluation.Thisveryusefulsection
isbasedonaseriesofquestionsandanswersaswellasonselectedclinicalcases.
I am especially indebted to L. Hendaoui for his relentless efforts to conduct
his project to final publication and his very productive cooperation with the
other co-editors: A. W. Stanson, M. H. Bouhaouala and F. Joffre.
This transatlantic and transmediterranean scientific venture has resulted in
anoutstandingvolumethatwillcertainlymeetahighinterestfromradiologists,
and vascular surgeons, pediatricians and medicalspecialists in various areas of
internalmedicine.Butalsootherphysiciansmayfinditveryusefulforlearning
more about the actual potential of medical imaging and thus for a better
management of vasculitis patients.
I am confident that this will meet the same success with the readers as the
previous volumes published in this series.
Albert L. Baert
vii
Preface
Vascular diseases represent one of the most frequent causes of death and
morbidity in the world. Inflammatory vascular diseases are not the most
common but have the peculiarity of a worldwide diffusion, as opposed to
vascular diseases provoked by atherosclerosis, which are prevalent in western
countries. For some of the diseases a geographical predominance was evident,
but for most, changing lifestyles and human relocation has created a wide-
spread dissemination.
In recent years, inflammatory angiopathies have benefited from progress in
diagnostic and interventional imaging. Beyond the progress in ultrasound and
tomographic imaging, recent years have seen the emerging of functional
imaging methods, like positron emission tomography, that can detect early
inflammationofthevascularwalls,determinethelevelofinflammatoryactivity
and track their progress under pharmacological treatment. Furthermore, the
significant and permanent progress of biology and pathophysiology of the
vascularwallallowsabetterunderstandingofthesediseasesandespeciallytheir
impact on vascular hemodynamics and the various components of the circu-
lating blood.
This work, initiated by Lotfi Hendaoui, is a book primarily centred on the
imaging of these various diseases, both in its diagnostic and interventional
aspects. Beyond this initial objective, the book also aims to integrate imaging
withintheoverallcareofthesepatients,notforgettingthepathophysiologyfor
understandinghowthesediversediseasesaffectarteriesorveins,largevesselsor
small vessels or capillaries. In addition, these diseases have variable effects on
vessel walls, ranging from stenosis to aneurysmal dilatation. The diagnostic
criteria for these complex diseases are often difficult to identify and affirm,
which requires common rules of identification.
The multiple therapeutic possibilities are also described in detail. All the
chapters adopt a similar plan, addressing different aspects of the clinical pre-
sentation, imaging andtherapeutic management.Thispresentation allows easy
comparison of these different diseases whose main characteristics are summa-
rizedinacomparativetableattheendofthebook.Thisbookwaswrittenbya
largepanelofauthors,representingdifferentgeographicalregions:Africa,Asia,
Europe and North America.
ix
x Preface
Forwritingthispreface,LotfiHendaouichosetoassociatearepresentative
of Vascular Medicine and a radiologist heavily involved in vascular imaging
diagnosisandtherapy.Thischoiceisconsistentwiththedualgoalofproviding,
from imaging, an extensive review of all inflammatory diseases of the vessels
and the problems they face in the twenty-first century.
Prof. Alessandra Bura
Prof. Francis Joffre
Acknowledgement
The authors gratefully acknowledge the support of:
Mrs Ste´phanie Alouache for the translation of some chapters manuscript;
Prof. Hammouda Boussen and
Mr Fethi El Effrit
xi
Contents
Part I Introducing Chapters
Historical Background of Vascular Imaging. . . . . . . . . . . . . . . . . . . . . 3
Anthony W. Stanson
Current Classifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Thara Larbi, Saloua Hamzaoui, Maya Abdallah, Mourad Ennafaa,
Ali Harmel, Kamel Bouslama, Lotfi Hendaoui, and Skander M’rad
Systemic Vasculitis: Anatomy and Histopathology . . . . . . . . . . . . . . . . 15
AhlemLahmar,SabehMzabi-Regaya,SamirBoubaker,
Nidhameddine Kchir, and Lotfi Hendaoui
Immunological Aspects of Systemic Vasculitis . . . . . . . . . . . . . . . . . . . 25
Melika Ben Ahmed and Hechmi Louzir
Medical Imaging Investigation of Vasculitis . . . . . . . . . . . . . . . . . . . . . 43
M. Habib Bouhaouala, Lotfi Hendaoui, Antony W. Stanson,
and Francis Joffre
Evaluation of Carotid Atherosclerosis and Inflammation by Contrast
Enhanced Ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Joseph Shalhoub, David R. J. Owen, and Edward L. S. Leen
Part II Vasculitis Involving Predominantly Large Vessels
Giant Cell Arteritis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Chad J. Fleming, Kenneth J. Warrington, James Glockner,
Dylan V. Miller, Jeremy L. Friese, and Anthony W. Stanson
Imaging Features of Takayasu Disease. . . . . . . . . . . . . . . . . . . . . . . . . 93
LotfiHendaoui,AnisAskri,MayaAbdallah,LeilaCharrada-BenFarhat,
A. Mourad Souissi, Skander Mrad, M. Habib Bouhaouala, and
Anthony W. Stanson
Cogan’s Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Eric L. Matteson and Anthony W. Stanson
xiii
