Rheumatology Unit, Department of Internal Medicine, Ophthalmology Unit, Department of Surgery, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Department of Internal Medicine, University of Messina, Messina and Pathology Unit, Department of Oncology, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy.
Rheumatology (Oxford). 2015 Mar;54(3):400-4. doi: 10.1093/rheumatology/keu241. Epub 2014 Jun 17.
The aim of this study was to assess the usefulness of colour duplex sonography (CDS)-guided temporal artery biopsy (TAB) for the diagnosis of GCA in patients with suspected GCA.
From September 2009 through December 2012, 112 consecutive patients with suspected GCA were randomized to undergo CDS-guided TAB or standard TAB. All patients underwent temporal artery physical examination and temporal artery CDS prior to TAB. CDS of the temporal artery was performed by the same ultrasonographer, who was unaware of the patient's clinical data, and all TABs were evaluated by the same pathologist. Seven patients in whom biopsy failed to sample temporal artery tissue were excluded from the analysis.
Fifty patients were randomized to undergo CDS-guided TAB and 55 patients to standard TAB. Except for a younger age in patients who underwent standard TAB (P = 0.026), no significant differences were observed between the two groups. There were no significant differences in the frequencies of positive TAB for classic transmural inflammation (28% vs 18.2%) or for periadventitial small vessel vasculitis and/or vasa vasorum vasculitis (6% vs 14.5%) between the two groups. No significant differences in the frequency of positive TAB in the two groups were observed when we excluded the patients treated with glucocorticoids and when we stratified the patients of the two groups for the presence or absence of the halo sign.
Our study showed that CDS-guided TAB did not improve the sensitivity of TAB for diagnosing GCA.
本研究旨在评估彩色双功能超声（CDS）引导颞动脉活检（TAB）在疑似巨细胞动脉炎（GCA）患者中的诊断价值。
2009 年 9 月至 2012 年 12 月，112 例疑似 GCA 的患者连续随机分为 CDS 引导 TAB 组或标准 TAB 组。所有患者在 TAB 前均进行颞动脉体格检查和颞动脉 CDS。由同一位超声医师进行颞动脉 CDS，该医师不了解患者的临床数据，所有 TAB 均由同一位病理学家评估。7 例活检未能采集颞动脉组织的患者被排除在分析之外。
50 例患者被随机分配至 CDS 引导 TAB 组，55 例患者被分配至标准 TAB 组。除标准 TAB 组患者年龄较小（P = 0.026）外，两组间无显著差异。两组经典贯穿性炎症（28%比 18.2%）或血管周围小血管炎和/或血管腔血管炎（6%比 14.5%）的阳性 TAB 频率无显著差异。当排除接受糖皮质激素治疗的患者和对两组患者的 halo 征存在与否进行分层时，两组的阳性 TAB 频率无显著差异。
我们的研究表明，CDS 引导 TAB 并未提高 TAB 诊断 GCA 的敏感性。
