Multimodality Imaging Features of Immunoglobulin G4-related Vessel Involvement.

IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiology. Cardiothoracic imaging Pub Date : 2024-04-01 DOI:10.1148/ryct.230105
Aileen O'Shea, Rory K Crotty, Mangun Kaur Randhawa, George Oliveira, Cory A Perugino, John H Stone, Mukesh G Harisinghani, Zachary S Wallace, Sandeep S Hedgire
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Abstract

Immunoglobulin 4 (IgG4)-related disease is a chronic immune-mediated fibroinflammatory disorder. Involvement of the vascular system, including large- and medium-sized vessels, is increasingly recognized. The varied appearances of vascular involvement reflect the sequela of chronic inflammation and fibrosis and can include aortitis and periaortitis with resultant complications such as aneurysm formation and dissection. A diagnosis of IgG4-related large vessel involvement should be considered when there is known or suspected IgG4-related disease elsewhere. Other organs that are typically affected in IgG4-related disease include the lacrimal and salivary glands, thyroid, pancreas, biliary tree, lungs, kidneys, and meninges. Diagnosis typically requires careful correlation with clinical, imaging, serum, and pathologic findings. Patients may be managed with corticosteroid therapy or the anti-CD20 monoclonal antibody, rituximab, if needed. The varied clinical presentations and imaging features of large vessel involvement are discussed herein. Keywords: Vascular, Inflammation, Aorta, IgG4-related Vessel Involvement © RSNA, 2024.

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免疫球蛋白 G4 相关血管受累的多模态成像特征
免疫球蛋白 4(IgG4)相关疾病是一种由免疫介导的慢性纤维炎症性疾病。越来越多的人认识到该病会累及血管系统,包括大血管和中血管。血管受累的表现多种多样,反映了慢性炎症和纤维化的后遗症,可包括主动脉炎和主动脉周围炎,并可导致动脉瘤形成和夹层等并发症。当已知或怀疑其他部位有 IgG4 相关疾病时,应考虑 IgG4 相关大血管受累的诊断。IgG4 相关疾病通常累及的其他器官包括泪腺和唾液腺、甲状腺、胰腺、胆道、肺、肾和脑膜。诊断通常需要与临床、影像学、血清和病理学检查结果仔细对照。必要时,患者可接受皮质类固醇治疗或抗CD20单克隆抗体利妥昔单抗治疗。本文讨论了大血管受累的不同临床表现和影像学特征。关键词血管 炎症 主动脉 IgG4 相关血管受累 © RSNA, 2024.
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