Abstract Details

Title The Diagnostic Utility of Cerebral Angiography for Primary Central Nervous System Vasculitis: Analysis of Patients from a Tertiary Centre

Topic Autoimmune Neurology

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 033

Objective

To further understand and research the diagnostic utility and effectiveness of investigations commonly used for primary central nervous system vasculitis (PCNSV) in patients with a compelling clinical course and features.

To explore the accuracy of this cerebral angiography (CA) in identifying PCNSV

Background PCNSV is an uncommon vasculitis of the central nervous system where the blood vessels of the cranial space are destroyed. Often this condition mimics the presentation of more common neurovascular illnesses, which leads to difficulty in the diagnosis of PCNSV. Calabrese and Mallek first described a set criteria for the diagnosis of PCNSV in 1988, which includes an acquired neurological deficit, a diagnostic CA with no evidence for systemic vasculitis or other mimics. Subsequently, CA is frequently cited for diagnosis of PCNSV.

Design/Methods A retrospective analysis was performed on the diagnostic process for 15 patients that were suspected of PCNSV on admission between 2010 and 2018. Vasculitic changes included in this study are as follows: beading, tapering of vessel lumen, fusiform arterial dilatations, collateral circulation, prolonged circulation time, delayed arterial emptying and multifocal vascular occlusions. Data on investigations conducted for each patient other than CA were analysed descriptively. Positive and negative predictive values were calculated to observe the accuracy of CA.

Results Most patients were referred for CA (n=14). Beading was a common finding amongst patients. From the data, CA has a positive predictive value of 85.7% for diagnosing PCNSV and a negative predictive value of 71.4% for PCNSV. Other than CA

Conclusions

These values suggest CA has a high probability of identifying PCNSV. With healthcare innovation incorporating modern imaging techniques, the role of newer technologies is an important consideration. Multi-centre data is necessary to identify accurate diagnostic processes for PCNSV. Updated criteria have the ability to improve patient safety and outcomes.

Authors/Disclosures
Abhishek K. Gupta PRESENTER	Mr. Gupta has nothing to disclose.
Saiju Jacob, MD, FAAN	Dr. Jacob has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ArgenX. Dr. Jacob has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Pharma. Dr. Jacob has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Regeneron Pharmaceuticals. Dr. Jacob has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion Pharmaceuticals. Dr. Jacob has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen Pharmaceuticals. Dr. Jacob has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Jacob has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Jacob has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB Pharmaceuticals. Dr. Jacob has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Terumo BCT. Dr. Jacob has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Argen X. Dr. Jacob has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.

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