Aortic aneurysms in patients with Takayasu's arteritis: CT evaluation

OBJECTIVE: The objective of this study was to evaluate the incidence, development, and outcome of aortic aneurysm on CT in a group of patients with Takayasu's arteritis. MATERIALS AND METHODS: We reviewed the files of 31 patients with Takayasu's arteritis between January 1990 and March 1999. All patients were followed up for more than 6 months with CT, and the mean follow-up period was 52.9 months (median, 36.0 months). In all patients, initial CT was performed within 6 months of diagnosis of Takayasu's arteritis. The study group comprised 24 female patients and seven male patients; their ages at the first CT examination ranged from 8 to 72 years (mean, 42. 6 +/- 16.5 years). RESULTS: Seventeen aortic aneurysms were found in 14 (45.2%) of the 31 patients. Patients with severe calcification of the aorta showed significantly lower incidence of aneurysm formation than those without severe calcification of the aorta (p < 0.05). Of the 17 aneurysms, three were not present at the time of initial CT and appeared during the follow-up period. Nine of 17 aneurysms increased in size during the follow-up period. Three of the nine aneurysms rapidly increased in size and ruptured during the follow-up period. In all three of these aneurysms, aortic wall thickening was identified on CT. The remaining six aneurysms slowly increased in size but did not rupture. CONCLUSION: Aortic aneurysm associated with Takayasu's arteritis is not rare. The aorta with little calcification has a greater possibility of aneurysm formation in patients with Takayasu's arteritis. Aortic aneurysms with wall thickening can have fatal consequences.