Aortitis

Aortitis is abnormal inflammation of the aortic wall

Caused by a broad category of infectious or noninfectious conditions in which there

  • Noninfectious aortitis occurs in large-vessel vasculitides
    • Takayasu arteritis
    • giant cell arteritis (GCA).
    • rheumatoid arthritis
    • SLE
    • ankylosing spondylitis.
    • reiters
  • Infectious aortitis may be secondary to
    • tuberculosis,
    • syphilis,
    • Salmonella or other bacterial or viral pathogens.

Clinical nonspecific and may include pain, fever

Diagnosis Imaging

magnetic resonance (MR) imaging, MR angiography, and computed tomographic angiography

noninfectious (more common)

Takayasu arteritis and giant cell arteritis (GCA). It is also seen in other collagen vascular disorders such as rheumatoid arthritis and ankylosing spondylitis

 

infectious

tuberculosis, syphilis, or infection with Salmonella or other bacterial or viral pathogens.

Etiology of Aortitisis
Rebello et al Radiographics

CT angiography has excellent spatial resolution and is commonly the initial imaging study (gated)

 

Magnetic resonance (MR) imaging is recommended for serial imaging

Nuclear medicine imaging with fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) or gallium 67 (67Ga) is helpful in assessment of inflammatory activity

GCA in a 72-year-old woman. Contrast-enhanced CT image shows diffuse abnormal thickening of the thoracic aorta. The thickening was due to an extensive intramural hematoma.
Radiographics Restrepo 2011
GCA in a 65-year-old woman. Contrast-enhanced CT images shows diffuse wall thickening of the thoracic aorta.
Radiographics Restrepo 2011
GCA in a 67-year-old woman. (a) Gradient-echo MR image, obtained at the level of the aortic root, shows abnormal thickening of the middle one-third of the descending aorta (arrow).
Radiographics Restrepo 2011
Fat-suppressed T2-weighted MR image shows increased signal intensity in the aortic wall (arrow), a finding consistent with edema.
Radiographics Restrepo 2011

References

1- Restrepo  et al Aortitis: Imaging Spectrum of the Infectious and Inflammatory Conditions of the Aorta,   Radiographics

TCV

Takayasu Aortitis