3D T1-weighted Black-blood Magnetic Resonance Imaging for the Diagnosis of Giant Cell Arteritis

Objectives: Imaging techniques have an increasing place in the diagnosis of giant cell arteritis (GCA). Achieving a confident diagnosis of GCA is often challenging and temporal artery biopsy is still considered as the gold standard despite the delayed results. 3T-MRI with 2D sequences has been evaluated for the detection of mural inflammation in extracranial arteries to support the diagnosis of GCA.

Methods: We evaluated the diagnostic performance of fat-suppressed 3D T1-weighted black-blood MRI (CUBE T1) with 3D TOF coregistration.

Results: Thirty-two patients with clinically suspected GCA were included and 10 had a diagnosis of GCA. Sensitivity and specificity of CUBE T1 were 80% and 100% respectively. Therefore, the positive predictive value of post-contrast CUBE T1 was 100% and the negative predictive value was 92%. Intra- and inter-observer agreement for mural enhancement on CUBE T1 was 1 and 0.83, respectively.

Conclusions: We demonstrate that CUBE T1 is accurate for the diagnosis of GCA. The reproducibility and short scan duration of the technique support a wider use of MRI in the diagnosis process.