Imaging of CNS Vasculitis

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Magnetic Resonance Imaging: 1.75
Patient Care: 0.25
Patient Interactions and Management: 0.25
Procedures: 1.50
Neurological: 1.50

Outline

1. Introduction
2. Classification
3. Methods of Examination
   1. Magnetic Resonance Imaging
   2. Computed Tomography
   3. Positron Emission Tomography/CT
   4. Color Duplex US
   5. Digital Subtraction Angiography
   6. Biopsy
4. Interpretation
   1. Parenchymal Changes
   2. Vascular Changes
   3. Associated Findings
5. Large-Vessel Vasculitis
   1. Takayasu Arteritis
   2. Giant Cell Arteritis
6. Vasculitis of Medium-sized Vessels
   1. Polyarteritis Nodosa
   2. Kawasaki Disease
7. Small-Vessel Vasculitis
   1. IgA Vasculitis
   2. Microscopic Polyangiitis
   3. Granulomatosis with Ployangiitis
   4. Eosinophilic Granulomatosis with Polyangiitis
8. Vasculitis of Variable-sized Vessels
   1. Bechet Disease
   2. Cogan Syndrome
9. Single-Organ Vasculitis
   1. Primary Angiitis of the CNS
   2. Reversible Cerebral Vasoconstriction Syndromes
   3. Moyamoya Disease
10. Vasculitis associated with Systemic Disease
    1. Systemic Lupus Erythematosus
    2. Sjˆgren Syndrome
    3. Rheumatoid Arthritis
    4. APLA Syndrome
    5. Scleroderma
11. Vasculitis Associated with Probable Cause
    1. Acute Septic Meningitis
    2. Tuberculous Vasculitis
    3. Neurosyphilis Vasculitis
    4. Varicella-Zoster Virus Vasculitis
    5. HIV-related Vascultisi
    6. Fungal Vasculitis
    7. Cysticercosis
    8. Malignancy-induced Vasculitis
    9. Drug-induced Vasculitis
    10. Radiation-induced Vasculitis
12. Conclusion

Objectives

Upon completion of this course, students will:

1. define cerebral vasculitis
2. identify the associations of CNS vasculitis
3. establish criteria for defining vasculitis
4. distinguish sensitivity from specificity
5. identify the importance of FLAIR imaging in MRI
6. establish the value of SWI in diagnosing microhemorrhages
7. identify which pathology CT is best suited for, relative to MRI
8. show the importance of DSA in small artery evaluation, compared to MRA and CTA
9. identify optimal sequences in evaluation of hemorrhage, hematoma or microbleeds
10. become familiar with the identifying characteristics of giant cell arteritis
11. identify the attributes of polyarteritis nodosa
12. identify the characteristics of Kawasaki disease
13. become familiar with the identifying characteristics of RCVS
14. establish criteria for identification of SLE
15. distinguish the advantages of MR sequences when evaluating for microbleeds in APLA syndrome
16. identify the characteristics of scleroderma
17. identify the most common cause of chronic meningitis
18. identify the characteristics of IgA vasculitis
19. describe and establish characteristics of drug-induced vasculitis
20. describe and define radiation-induced vasculitis