CT and MRI of Cardiothoracic 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.]

Cardiac-Interventional Radiography: 3.00
Procedures: 3.00
Diagnostic and Conduction System Studies: 1.50
Hemodynamics, Calculations, and Percutaneous Intervention: 1.50

Computed Tomography: 2.50
Procedures: 2.50
Neck and Chest: 2.50

Magnetic Resonance Imaging: 0.50
Procedures: 0.50
Body: 0.50

Registered Radiologist Assistant: 3.00
Procedures: 3.00
Thoracic Section: 2.50
Neurological, Vascular, and Lymphatic Sections: 0.50

Outline

1. Introduction
2. Imaging Modalities
3. Spectrum of Cardiac Involvement
   1. Aorta and Great Vessels
   2. Pulmonary Hypertension
   3. Pericarditis
   4. Myocarditis
   5. Endocardial Involvement and Valvular Disease
   6. Coronary Involvement
      1. Epicardial Coronary Arteritis and Coronary Artery Encasement
      2. Microvascular Disease
      3. Detection of Fibrosis and Viability
4. Vasculitis Involving the Heart
   1. Large Vessel Vasculitis
      1. Great Vessel Disease
      2. Valvular Disease
      3. Coronary Artery Disease
      4. Other Patterns of Disease
   2. Medium Vessel Vasculitis
      1. Polyarteritis Nodosa
      2. Kawasaki Disease
   3. Small Vessel Vasculitis
      1. Eosinophilic Granulomatosis with Polyangitis
      2. Granulomatosis with Polyangitis and Microscopic Polyangitis
      3. Cryoglobulinemic Vasculitis
   4. Variable Vessel Vasculitis
   5. Other Entities with a Vasculitic Component
      1. Rheumatoid Arthritis
      2. Systemic Lupus Erythematosus
      3. IgG4-related Disease
5. Diagnostic Imaging Strategy
6. Conclusion

Objectives

Upon completion of this course, students will:

1. be familiar with conditions related to secondary vasculitis
2. identify the diseases included in the large vessel vasculitis category
3. be familiar with the complications associated with coronary vasculitis
4. identify the advantages of cardiac CT when assessing the great vessels and coronary arteries
5. be familiar with the global assessment of the cardiovascular system that cardiac MR offers
6. understand the differences between MR angiography and CT angiography when detecting stenoses and aneurysms in patients with vasculitis
7. be familiar with the MR imaging techniques employed to determine pulmonary transit time
8. be familiar with Lake Louise Criteria for diagnosis of myocarditis
9. identify the first-line modality for cardiac valvular assessment
10. identify the best noninvasive technique for coronary artery evaluation
11. be familiar with alternatives for assessing myocardial perfusion with cardiac MR
12. be familiar with the main sources of errors in vasodilator stress cardiac MR imaging
13. be familiar with the causes of coronary artery encasement
14. be familiar with the population at greatest risk for giant cell arteritis
15. identify the class Ia diagnosis standard for giant cell arteritis
16. be familiar with the diagnostic criteria for Takayasu patients
17. be familiar with the diagnostic criteria for giant cell arteritis
18. identify the imaging modalities used for accurate gradations of aortic insufficiency
19. be familiar with the similar findings in both Takayasu and giant cell arteritis
20. identify the leading cause of mortality in patients suffering with Takayasu arteritis
21. be familiar with the recommended therapeutic options for treating patients with larger vessel vasculitis
22. identify the two main medium vessel vasculitides involving the heart
23. identify the virus associated with poly arteritis nodosa vasculities
24. be familiar with the diagnostic criteria for polyarteritis nodosa
25. be familiar with the population most affected by Kawasaki disease
26. be familiar with the diagnostic criteria for Kawasaki disease
27. be familiar with the percentage of Kawasaki patients suffering from myocarditis
28. identify the risks for developing coronary artery aneurysms in patients with Kawasaki disease
29. identify the first-choice imaging modality for the assessment of cardiac involvement in patients with Kawasaki disease
30. be familiar with the small vessel vasculitides
31. identify the small vessel diseases that are included ANCA-associated vasculitis
32. be familiar with the factors increasing cardiovascular risks associated with small vessel diseases
33. be familiar with the indicators for eosinophilic granulomatosis with polyangitis
34. be familiar with the most common pattern of cardiac involvement of patients with eosinophilic granulomatosis
35. be familiar with the diagnostic criteria for eosinophilic granulomatosis
36. be familiar with the cardiac involvement associated with granulomatosis with polyangitis
37. identify the types of cryoglobulinemic vasculitis frequently associated with rheumatoid factor
38. identify the diseases in the category of variable vessel vasculitis
39. be familiar with the minor diagnostic criteria for cryoglobulinemic vasculitis
40. be familiar with the cardiac manifestations of rheumatoid arthritis