Imaging of CNS Vasculitis

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after May 25, 2023:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 3.00
Procedures: 3.00
Head, Spine, and Musculoskeletal: 3.00

Magnetic Resonance Imaging: 3.00
Procedures: 3.00
Neurological: 3.00

Nuclear Medicine Technology: 1.00
Procedures: 1.00
Other Imaging Procedures: 1.00

Registered Radiologist Assistant: 3.00
Procedures: 3.00
Neurological, Vascular, and Lymphatic Sections: 3.00

Vascular-Interventional Radiography: 3.00
Procedures: 3.00
Vascular Diagnostic Procedures: 3.00

Vascular Sonography: 0.50
Procedures: 0.50
Extracranial Cerebral Vasculature and Other Sonographic Procedures: 0.50

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. learn the manifestations of cerebral vasculitis
3. identify the associations of CNS vasculitis
4. identify the indications of cerebral vasculitis
5. establish criteria for defining vasculitis
6. define sensitivity and specificity
7. distinguish sensitivity from specificity
8. identify the most common imaging modality in diagnosing vasculitis
9. identify the importance of FLAIR imaging in MRI
10. establish the value of SWI in diagnosing microhemorrhages
11. identify the optimal imaging technique in the evaluation of Takayasu arteritis
12. identify which pathology CT is best suited for, relative to MRI
13. identify the value of perfusion CT in the setting of vasculitis
14. identify the optimal imaging method for visualizing the “halo sign” in patients with acute temporal arteritis
15. show the importance of DSA in small artery evaluation, compared to MRA and CTA
16. identify optimal sequences in evaluation of hemorrhage, hematoma or microbleeds
17. become familiar with the identifying characteristics of Takayasu arteritis
18. become familiar with the identifying characteristics of giant cell arteritis
19. identify the attributes of polyarteritis nodosa
20. identify the characteristics of Kawasaki disease
21. distinguish the characteristic findings of Wegener granulomatosis
22. define and identify the traits of Behcet disease
23. become familiar with the identifying characteristics of RCVS
24. identify the characteristics of moyamoya disease
25. establish criteria for identification of SLE
26. distinguish the advantages of MR sequences when evaluating for microbleeds in APLA syndrome
27. identify the characteristics of scleroderma
28. identify the most common cause of chronic meningitis
29. identify the characteristics of neurosyphilis vasculitis
30. define VZV and establish the manifestations of the disease
31. identify the characteristics of IgA vasculitis
32. identify the fusiform characteristic of HIV-related aneurysms
33. identify the characteristics and imaging value of cysticercosis
34. describe and establish characteristics of drug-induced vasculitis
35. describe and define radiation-induced vasculitis