Imaging description

Takayasu's arteritis is a chronic vasculitis of unknown etiology, which primarily affects the aorta and its primary branches. Fever, malaise, and weight loss are the most common symptoms. Takayasu's arteritis primarily afflicts women and Asians. The arteritis may be localized to a segment of any large artery or may involve the aorta and multiple vessels contiguously [1–3]. PET/CT demonstrates intense FDG uptake within the thickened, inflamed arterial walls (Figure 81.1). PET/CT is more sensitive than CT and MRI in detecting disease extent and identifying segmental arteritis. PET/CT can distinguish vessel thickening due to fibrosis from active inflammation. FDG uptake correlates with clinical markers of inflammation and can be used to evaluate response to therapy [4].

Importance

Takayasu's arteritis often presents with nonspecific clinical findings, often suggestive of an underlying malignancy. Overlooking the diffuse arterial wall activity can lead to adverse consequences for the patient. The moderate to intense linear FDG accumulation within the walls of the great vessels should not be confused as secondary to atherosclerotic disease.