3-T MRI reveals cranial and thoracic inflammatory changes in giant cell arteritis.

Giant cell arteritis (GCA) is a diagnostic challenge. The correct diagnosis is needed for immediate initiation of corticosteroid treatment since blindness is a dreaded complication. Typically, the superficial cranial arteries are affected by this granulomatous vasculitis of large- and medium-sized arteries. However, GCA is not limited to the cranial arteries. Involvement of various arteries such as the cervical and thoracic arteries can also occur. Here, we report a case of histologically proven GCA with cranial and extracranial involvement. We illustrate the usefulness of a comprehensive vascular high-resolution magnetic resonance imaging examination that combines assessment of mural inflammatory changes of the small temporal and occipital arteries with the evaluation of extracranial vasculature to assist in the difficult non-invasive diagnosis and to determine the extent of this inflammatory disease.