Diagnostic value of T2-weighted imaging for the detection of superficial cranial artery inflammation in giant cell arteritis

Purpose: To evaluate the diagnostic value of T2-weighted radial MR imaging for the detection of superficial cranial arteries' inflammatory involvement in patients with giant cell arteritis (GCA). Materials and Methods: Forty-three patients with suspected giant cell arteritis underwent 3 Tesla (T) high-field MRI. T2-weighted inversion recovery (IR) fast spin echo images with radial sampling (BLADE-technique) were acquired and compared with postcontrast T1-weighted spin echo images. Results: T2-weighted images revealed mural edema in the superficial cranial arteries in 11 patients in concordance with severe inflammatory contrast enhancement in T1-weighted images (grade 4 in a 4-point ranking scale). Excellent correlation (r = 0.82; P < 0.001) of measured wall thickness in T1- and T2-weighted images was achieved. Conclusion: The results of this study indicate the potential of radial T2 weighted imaging for a first detection of inflammatory changes in the small superficial cranial arteries without the need for contrast medium. Future studies are needed to evaluate the influence of spatial resolution of the T2 images and to improve the detection of moderate GCA related changes in vessel inflammation.