American Board of Internal Medicine (ABIM) Certification Practice Exam

What imaging technique can be used to confirm the diagnosis of Takayasu arteritis?

1. CT scan of the chest

2. Ultrasound of the abdomen

3. Arteriography of the aorta and its branches

4. X-ray of the neck

The correct answer is: Arteriography of the aorta and its branches

The confirmation of Takayasu arteritis is best achieved through arteriography of the aorta and its branches. This imaging technique is particularly effective because it allows for direct visualization of the vascular structures involved in the disease. Takayasu arteritis primarily affects large vessels, especially the aorta and its major branches, leading to stenosis or occlusion. Arteriography can show these changes clearly, demonstrating narrowing or blockage of blood vessels, which is crucial for diagnosis. In contrast, while CT scans might provide some information about vascular structures, they are not as definitive for demonstrating the specific lesion characteristics typical of Takayasu arteritis. Ultrasound of the abdomen is generally not used for this condition, as it does not adequately assess large vessel involvement or the aortic arch. An X-ray of the neck lacks the sensitivity and specificity required to evaluate large vessel disease, making it unsuitable for confirming Takayasu arteritis. The detailed assessment provided by arteriography makes it the preferred choice for accurate diagnosis.