双侧颞动脉活检诊断巨细胞动脉炎时不一致结果的发生率。
Rate of discordant findings in bilateral temporal artery biopsy to diagnose giant cell arteritis.
作者信息
Breuer Gabriel S, Nesher Gideon, Nesher Ronit
机构信息
Department of Internal Medicine, Rheumatology Service, Shaare-Zedek Medical Center, Hebrew University Medical School, PO Box 3235, Jerusalem, Israel 91031.
出版信息
J Rheumatol. 2009 Apr;36(4):794-6. doi: 10.3899/jrheum.080792. Epub 2009 Feb 17.
OBJECTIVE
To determine to what extent performing simultaneous bilateral temporal artery biopsies might increase the diagnostic sensitivity in giant cell arteritis (GCA).
METHODS
In total 173 consecutive pathology reports of temporal artery biopsies were reviewed for histological findings by a single pathologist. The rate of discordance of biopsy results was calculated in patients with GCA.
RESULTS
Biopsies were performed bilaterally and simultaneously in 132 cases; 51 had positive results. In 38 the biopsy was positive on both sides (concordant results), while in 13 patients only one side was positive (discordant results), reaching a discordance rate of 13/51=0.255. Therefore 12.7% of the patients (one-half of the discordance rate) could have been misdiagnosed as biopsy-negative had a biopsy been done only unilaterally in those 51 cases.
CONCLUSION
These data suggest that performing bilateral temporal artery biopsies increases the diagnostic sensitivity of the procedure by up to 12.7%, compared to unilateral biopsies.
目的
确定同时进行双侧颞动脉活检在多大程度上可能提高巨细胞动脉炎（GCA）的诊断敏感性。
方法
由一名病理学家对总共173份连续的颞动脉活检病理报告进行组织学检查结果回顾。计算GCA患者活检结果的不一致率。
结果
132例患者进行了双侧同时活检；51例结果为阳性。38例双侧活检均为阳性（结果一致），而13例患者仅一侧为阳性（结果不一致），不一致率为13/51 = 0.255。因此，在这51例患者中，如果仅进行单侧活检，12.7%的患者（不一致率的一半）可能被误诊为活检阴性。
结论
这些数据表明，与单侧活检相比，进行双侧颞动脉活检可使该检查的诊断敏感性提高多达12.7%。
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