Rheumatology Department, NDORMS, Nuffield Orthopaedic Centre, University of Oxford, Oxford, UK.
Department of Rheumatology, IRCCS Policlinico S. Matteo Foundation, University of Pavia, Pavia, Italy.
Rheumatology (Oxford). 2018 Feb 1;57(2):227-235. doi: 10.1093/rheumatology/kex173.
Colour duplex sonography (CDS) of temporal arteries and large vessels is an emerging diagnostic tool for GCA. CDS can detect wall oedema, known as a halo, throughout the length of the vessel and shows higher sensitivity compared with biopsy. Specificity reaches 100% in case of bilateral halos. A positive compression sign has been demonstrated to be a robust marker with excellent inter-observer agreement. The assessment of other large vessels, particularly the axillary arteries, is recognized to further increase the sensitivity and to reliably represent extra-cranial involvement in other areas. Nevertheless, CDS use is still not widespread in routine clinical practice and requires skilled sonographers. Moreover, its role in the follow-up of patients still needs to be defined. The aim of this review is to provide the current evidence and technical parameters to support the rheumatologist in the CDS evaluation of patients with suspected GCA.
彩色双功能超声（CDS）检测颞动脉和大血管是一种新兴的巨细胞动脉炎（GCA）诊断工具。CDS 可以检测到整个血管长度的壁水肿，称为晕环，其敏感性高于活检。在双侧晕环的情况下，特异性达到 100%。阳性压迫征已被证明是一种具有出色观察者间一致性的可靠标志物。评估其他大血管，特别是腋动脉，被认为可以进一步提高敏感性，并可靠地代表其他区域的颅外受累。然而，CDS 在常规临床实践中的应用仍不广泛，需要熟练的超声技师。此外，其在患者随访中的作用仍有待确定。本文旨在提供当前的证据和技术参数，以支持风湿科医生对疑似 GCA 患者进行 CDS 评估。
