Roncato Christophe, Allix-Béguec Caroline, Brottier-Mancini Elisabeth, Gombert Bruno, Denis Guillaume
Angiology Department, Groupe Hospitalier de la Rochelle Ré Aunis, La Rochelle, France.
Clinical Research Unit, Groupe Hospitalier de la Rochelle Ré Aunis, La Rochelle, France.
Clin Exp Rheumatol. 2017 Mar-Apr;35 Suppl 103(1):119-122. Epub 2017 Mar 20.
Giant cell arteritis (GCA) is a vasculitis that occurs in older adults, affecting vessels of medium and large caliber. GCA diagnosis is a challenge for general practitioners and specialists. The aim of this study was to retrospectively analyse performances of temporal artery biopsy (TAB) and colour duplex ultrasonography (CDU) for GCA diagnosis.
All patients with suspicion of GCA and who underwent both TAB and CDU between April 2009 and March 2014 were included in the study. A positive CDU examination was defined by halos on both superficial temporal arteries. Patients were classified based on the physician final diagnosis.
Among the 42 eligible patients, 12 had an alternative diagnosis and 30 were diagnosed with GCA. Sensitivities were 77% and 80% for TAB and CDU examinations, respectively. Specificities were 100% for both tests. Twenty-nine (96.7%) patients with GCA had their diagnosis confirmed either by CDU and/or by TAB. Time lengths between the first medical examination and results of TAB and CDU were 15 and 4.2 days (p<0.001), respectively.
Our study suggests that in suspected GCA, CDU may be used as first line examination followed by TAB in case of CDU negative results. Such algorithm needs to be further assessed in a multicentre prospective study.
巨细胞动脉炎（GCA）是一种发生于老年人的血管炎，累及中、大动脉。GCA的诊断对全科医生和专科医生来说都是一项挑战。本研究的目的是回顾性分析颞动脉活检（TAB）和彩色双功超声检查（CDU）在GCA诊断中的表现。
纳入2009年4月至2014年3月期间所有疑似GCA且同时接受了TAB和CDU检查的患者。CDU检查阳性定义为双侧颞浅动脉出现晕征。根据医生的最终诊断对患者进行分类。
在42例符合条件的患者中，12例有其他诊断，30例被诊断为GCA。TAB和CDU检查的敏感性分别为77%和80%。两种检查的特异性均为100%。29例（96.7%）GCA患者通过CDU和/或TAB确诊。首次医学检查与TAB和CDU结果之间的时间间隔分别为15天和4.2天（p<0.001）。
我们的研究表明，在疑似GCA时，CDU可作为一线检查，若CDU结果为阴性，则进行TAB检查。这种检查流程需要在多中心前瞻性研究中进一步评估。
