Takayasu Arteritis with predominantly pulmonary involvement diagnosed by CT angiography

Summary 

A 19-year-old female was diagnosed with Takayasu's Arteritis (TA) following CT angiography (CTA). The striking feature, to our knowledge not previously described in the literature, was marked pulmonary arterial (PA) involvement with a cuff of tissue up to 1cm thick encasing lobar arteries whose lumen centrally was reduced to 4mm. Clinical and plain film respiratory manifestations are often absent in TA but PA involvement is common (50–80% prevalence). CTA has superseded conventional angiography as the investigation of choice, allowing the acquisition of enhanced thin section images, in multiple phases of vessel opacification, showing enhancing circumferential mural thickening as well as luminal narrowing. Radiological evaluation of the pulmonary arteries should be performed even in the absence of respiratory symptoms.

Keywords: Takayasu Arteritis, Pulmonary arteries, Computed tomography (CT)

Abbreviations: CT, computed tomography, CTA, computerised tomography angiography, ESR, erythrocyte sedimentation rate, ECG, electro cardiogram, MDCT, multi-detector CT, PA, pulmonary arterial, RBBB, right bundle branch block, TA, Takayasu's Arteritis, UK, United Kingdom