Possibilities and prospects of diagnostic imaging of non-specific Takayasu aortoarteriitis: a review

INTRODUCTION: Takayasu’s aortoarteritis (TA) is a chronic inflammatory systemic vasculitis affecting large vessels, primarily the aorta and its branches. The disease is more common in young women and leads to progressive stenosis, occlusion, aneurysms, and severe systemic complications.

Diagnosis of Takayasu’s disease is based on a comprehensive assessment of the clinical picture, laboratory data, and imaging techniques such as magnetic resonance angiography, computed tomography angiography, ultrasound, positron emission tomography, and digital subtraction X-ray angiography. Accurate diagnosis is critical for timely initiation of therapy and prevention of complications.

OBJECTIVE: To highlight the key aspects of the etiopathogenesis and clinical presentation of the disease. To analyze and systematize current diagnostic imaging capabilities for Takayasu’s disease, based on the ACR/EULAR-2022 consensus of professional societies. To demonstrate typical radiographic patterns of the disease. To highlight the capabilities and prospects of new diagnostic techniques, including spectral (dual-energy) computed tomography.

MATERIALS AND METHODS: A search was conducted in the scientific databases PubMed/MEDLINE, Web of Science, eLibrary using keywords: «nonspecific Takayasu’s aortoarteritis», «Takayasu’s disease», in combination with «radiation diagnostics», «ultrasound», «MRI», «spectral CT», «PET-CT». Inclusion criteria: professional society guidelines (EULAR, ACR/VF), systematic reviews/meta-analyses, and original studies on the imaging of Takayasu’s disease. Duplicates and irrelevant publications were excluded. Data on the etiopathogenesis of the disease, the objectives of diagnostic methods, diagnostic criteria, the accuracy of the methods, limitations, and dose load were extracted.

RESULTS: A total of 173 scientific publications were analyzed, 36 of which were used to compile this review. This review presents data on the key aspects of the etiopathogenesis of Takayasu’s disease and its clinical diagnostic criteria. It also highlights issues of multimodal imaging diagnostics, indicating the sensitivity and specificity of diagnostic techniques. It also examines the capabilities and prospects of spectral (dual-energy) computed tomography and other new imaging techniques.

CONCLUSION: Modern diagnostic imaging methods play a key role in the diagnosis and treatment monitoring of Takayasu’s disease. Their use, in accordance with the clinical task being addressed, significantly contributes to the comprehensive diagnosis of the disease, enabling the development of optimal treatment strategies aimed at reducing the risk of complications and improving patients’ quality of life.

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