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Rofo 2024; 196(04): 363-369
DOI: 10.1055/a-2185-8472
Review

Bildgebung von Amyloid-related Imaging Abnormalities (ARIA)

Artikel in mehreren Sprachen: English | deutsch
Horst Urbach 
1   Dept. of Neuroradiology, University Medical Center Freiburg, Germany
,
Jennifer Linn
2   Dept. of Neuroradiology, University Medical Center Dresden, Germany
,
Elke Hattingen
3   Dept. of Neuroradiology, University Medical Center Frankfurt, Germany
,
Jochen Fiebach
4   CSB-Neuroradiology, Charite University Hospital Berlin, Germany
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Zusammenfassung

Bei mittlerweile zugelassenen Therapien der Alzheimer-Erkrankung mit monoklonalen Antikörpern, die Amyloid aus dem Hirnparenchym „herauswaschen“ sollen, kann es zu Veränderungen in der MRT-Bildgebung kommen. Diese Veränderungen werden unter dem Begriff Amyloid-related Imaging abnormalities (ARIA) zusammengefasst. Es handelt sich um vasogene Ödeme und leptomeningeale Effusionen (ARIA-E) sowie Mikroblutungen und superfizielle Hämosiderosen (ARIA-H). Das Auftreten ist Medikamenten- und dosisabhängig (bis 40 % der Patienten), die Apolipoprotein E 4-Variante und eine zerebrale Amyloid-Angiopathie (CAA) als Komorbidität erhöhen das Risiko. In der Bildgebung sind ARIA und die sog. inflammatorische, möglicherweise autoimmunologisch verursachte CAAri (CAA-related inflammation CAA-ri) nicht unterscheidbar. Patienten mit CAA-ri werden in der Regel aufgrund von Symptomen (Kopfschmerzen, Lethargie, Verwirrung, seltener epileptische Anfälle auffällig, ARIA-Patienten sind in etwa 20 % der Fälle symptomatisch. Das weitere Vorgehen bei Nachweis von ARIA ist noch unklar, zunächst wird häufig lediglich das Medikament abgesetzt.

Kernaussagen 

  • Amyloid-related imaging abnormalities (ARIA) treten in ca. 20 % der Patienten auf, die mit gegen Amyloid β gerichteten monoklonalen Antikörpern behandelt werden.

  • Es werden ARIA-E (edema effusion) und ARIA-H (hemorrhage) unterschieden.

  • In Anhängigkeit vom Schweregrad wird die Therapie pausiert oder abgebrochen.

Zitierweise

  • Urbach H, Linn J, Hattingen E et al. Imaging of Amyloid-Related Imaging Abnormalities (ARIA). Fortschr Röntgenstr 2024; 196: 363 – 370

Keywords

MR-imaging - Alzheimer disease - dementia


Publikationsverlauf

Eingereicht: 29. Mai 2023

Angenommen: 02. September 2023

Artikel online veröffentlicht:
23. November 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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