Objective Few reports are seen on Takayasu arteritis (TA). This paper was to evaluate the CT presentations of TA and the role CT in its diagnosis and follow-up by analyzing the CT angiography (CTA) of the disease. Methods We retrospectively analyzed 27 cases of clinically confirmed TA, that underwent dual-source CTA of the neck, thorax and abdomen ( n = 7) , neck and thorax ( n = 1) , thorax and abdomen ( n = 8 ) , abdomen (n = 4) , or whole body ( n = 7). Six of the patients were followed up by CT studies postoperatively. Results Of the 378 vascular segments evaluated, 245 were found involved, with obvious thickening of the vascular walls, 42 segments in 16 cases with severe stenosis and/or occlusion, 20 segments in IS cases with luminal extension, 3 segments in 3 cases with aneurysm, and 11 cases with vascular wall calcification. Five patients exhibited pulmonary artery involvement and associated pulmonary hypertension, 5 presented severe renal artery stenosis and/or occlusion and associated renal atrophy, and 19 showed collateral circulation. Of the 6 patients followed up by CT studies, 4 underwent stent placement, and 2 bypass graft. Follow-up findings revealed stent-in restenosis in 1 case, but no abnormality in all the other 5. Conclusion Vascular thickening, stenosis or occlusion and associated collateral circulation, and poststenosis dilation are common CT findings of TA. Dual-source CTA plays a valuable role in the diagnosis and follow-up of TA.%目的 关于大动脉炎国内外报道较少.文中总结分析大动脉炎的CT血管成像(CT angiography,CTA)表现,评价大动脉炎的CT表现及其在大动脉炎的诊断和随访中的价值. 方法 回顾性分析2007年1月至2011年1月27例临床确诊为大动脉炎患者的CTA资料,其中7例行颈胸腹部CTA、8例行胸腹部CTA、1例行颈胸部CTA、4例行腹部CTA、7例行颈部CTA.6例患者术后随访CT. 结果 所有患者共评价378段大血管,245段血管受累,管壁增厚.16例患者42段血管管腔重度狭窄或闭塞,15例患者20段管腔扩张,其中3例患者动脉瘤形成；11例患者主动脉管壁合并钙化.5例患者合并出现单侧肺动脉受累合并肺动脉高压(左侧4例、右侧1例)；5例单侧肾动脉重度狭窄或闭塞继发同侧肾脏萎缩；19例患者可见明显侧枝循环形成,其中以肠系膜上下动脉间的侧枝较多见.6例随访患者CTA中,4例行支架植入手术,2例行血管旁路手术,其中1例患者支架内血栓形成,另5例患者术后支架及旁路血管管腔均通畅. 结论 管壁增厚、管腔狭窄或闭塞、侧枝循环以及狭窄后扩张是大动脉炎的常见CT表现.多层螺旋CT在大动脉炎的诊断和随访中具有重要价值.
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