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Tests and diagnosis
By Mayo Clinic staffTakayasu's arteritis can be challenging to detect, and some people go years without an accurate diagnosis. In addition to taking your medical history and conducting a physical exam, your doctor may use some of the following tests to help rule out other conditions that closely resemble Takayasu's arteritis and confirm the diagnosis:
- Blood tests. Your doctor may order blood tests to check for signs of inflammation in your body, such as a high white blood cell count or high levels of C-reactive protein, an inflammatory substance produced by your liver. Another blood test commonly used to help identify inflammatory disorders is called the erythrocyte sedimentation rate (sed rate). It measures the speed at which red blood cells sink to the bottom of a glass tube. Generally, when inflammation is present, red blood cells clump together and settle more rapidly than normal, causing the sed rate to increase. Your doctor may also check the number of red blood cells for anemia.
- Angiography. Traditionally, doctors have used an X-ray test called an angiogram as one of the more definitive tests for diagnosing Takayasu's arteritis. During an angiogram, a thin, flexible tube called a catheter is inserted into a large blood vessel. A special dye (contrast medium) is then injected into the catheter, and X-rays are taken as the dye fills your arteries or veins. The resulting images allow your doctor to see if blood is flowing normally through your blood vessels or if it's being slowed or interrupted due to narrowing (stenosis) or blockage of a blood vessel. A person with Takayasu's arteritis generally has several areas of stenosis.
- Magnetic resonance angiography (MRA). Increasingly, doctors are using this less invasive form of angiography in place of traditional angiography as a test for Takayasu's arteritis. MRA produces detailed images of your blood vessels without the use of catheters or X-rays, although a contrast medium generally is used. MRA works by using radio waves in a strong magnetic field to produce data that a computer turns into detailed images of tissue slices.
- Magnetic resonance imaging (MRI). An MRI is similar to an MRA in that it uses radio waves and a magnetic field to create detailed images of organs in the body and allows your doctor to check for possible damage. MRI doesn't use a contrast medium, however.
- Computerized tomography (CT) angiography. This is another noninvasive form of angiography combining computerized analysis of X-ray images with the use of contrast dye to allow your doctor to check the structure of your aorta and its nearby branches, and to monitor blood flow.
- Ultrasonography. Doppler ultrasound, a more sophisticated version of the common ultrasound, has the ability to produce very high-resolution images of the walls of certain arteries, such as the common carotid and subclavian arteries. It may be able to detect subtle changes in these arteries before other imaging techniques can. Doppler ultrasound can also help distinguish between Takayasu's arteritis and atherosclerosis, a much more common condition caused by the buildup of cholesterol particles and other cellular debris in your arteries.
Because Takayasu's arteritis has a tendency to recur or "flare up" after being in remission for a while, these tests may be used not only for diagnosis but also for monitoring the progress of the disease and following up on effectiveness of treatment. Some of the medications used for Takayasu's arteritis may have potentially harmful effects over the long run, so it's important for you and your doctor to know when medication is beneficial and when its risks outweigh its benefits.
- Anton E. Large vessel arteritis: A diagnostic challenge in the elderly. Journal of Clinical Pathology. 2005;58(7):782.
- Vasculitis syndromes of the central and peripheral nervous systems fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/vasculitis/detail_vasculitis.htm. Accessed Aug. 8, 2008.
- Johnston SL, et al. Takayasu arteritis: A review. Journal of Clinical Pathology. 2002;55(7):481-486.
- Takayasu's arteritis. Merck Manuals Online Medical Library. http://www.merck.com/mmhe/sec05/ch069/ch069f.html. Accessed Aug. 8, 2008.
- Kis B, et al. Severe supraaortal atherosclerotic disease resembling Takayasu's arteritis. Vascular Health Risk Management. 2007;3(3):351-354.
- Kissin EY, et al. Diagnostic imaging in Takayasu arteritis. Current Opinion in Rheumatology. 2004;16(3):31-37.
- Liang P, et al. Advances in the medical and surgical treatment of Takayasu arteritis. Current Opinion in Rheumatology. 2005;17(1):16-24.
- de Franciscis S, et al. The management of Takayasu's arteritis: Personal experience. Annals of Vascular Surgery. 2007;21(6):754-760.
