Department of Vascular Surgery, Norfolk and Norwich University Hospital, Norwich, UK.
Br J Surg. 2010 Dec;97(12):1765-71. doi: 10.1002/bjs.7252.
Temporal artery (TA) biopsy is the current standard for diagnosing temporal arteritis, but has limited sensitivity. Colour duplex ultrasonography is a newer, non-invasive method of diagnosing temporal arteritis.
A systematic review was performed of trials comparing TA biopsy with duplex ultrasonography. Duplex results (halo sign, stenosis or vessel occlusion) were compared with either TA biospy findings or the American College of Rheumatology research criteria for diagnosing temporal arteritis. Trials were identified from MEDLINE, Embase and the Cochrane Library trials register. The performance of duplex ultrasonography was assessed with weighted independent sensitivity and specificity values, and summary receiver operating characteristic curve analysis.
There were 17 eligible studies containing 998 patients. When the halo sign on duplex imaging was compared with TA biopsy, the sensitivity was 75 (95 per cent confidence interval 67 to 82) per cent and the specificity was 83 (78 to 88) per cent. There was no heterogeneity across the eligible studies.
Duplex ultrasonography was relatively accurate for diagnosing temporal arteritis. It should become the first-line investigation, with biopsy reserved for patients with a negative scan.
颞动脉（TA）活检是目前诊断巨细胞动脉炎的标准方法，但敏感性有限。彩色双功能超声是一种新的、非侵入性的诊断巨细胞动脉炎的方法。
对比较 TA 活检与双功能超声的试验进行了系统评价。将双功能超声结果（晕环征、狭窄或血管闭塞）与 TA 活检结果或美国风湿病学会诊断巨细胞动脉炎的研究标准进行比较。从 MEDLINE、Embase 和 Cochrane 图书馆试验登记处确定试验。使用加权独立敏感性和特异性值以及汇总受试者工作特征曲线分析评估双功能超声的性能。
有 17 项符合条件的研究包含 998 例患者。当将双功能超声上的晕环征与 TA 活检进行比较时，敏感性为 75%（95%置信区间 67%至 82%），特异性为 83%（78%至 88%）。合格研究之间没有异质性。
双功能超声对于诊断巨细胞动脉炎相对准确。它应该成为一线检查，对于扫描阴性的患者保留活检。
