University Medical Centre Ljubljana, Department of Rheumatology, Vodnikova cesta 62, SI-1000 Ljubljana, Slovenia.
University Medical Centre Ljubljana, Department of Rheumatology, Vodnikova cesta 62, SI-1000 Ljubljana, Slovenia.
Eur J Radiol. 2017 Oct;95:9-12. doi: 10.1016/j.ejrad.2017.07.007. Epub 2017 Jul 16.
Colour Doppler Sonography (CDS) in giant cell arteritis (GCA) allows the study of involvement of cranial arteries other than the temporal arteries, which are inconvenient to biopsy, such as the facial (FaA), and occipital (OcA) arteries. We aimed to estimate the frequency of the FaA, and OcA involvement in GCA; and to explore the clinical characteristics of these subgroups of patients.
From 1 January 2014 to 31 December 2016 we prospectively performed a CDS of the FaA, and OcA in addition to the temporal (TA), and the extracranial supra-aortic arteries in all newly diagnosed patients suspected of having GCA. All the arteries were evaluated in two planes for the highly specific halo sign.
During the 36-month observation period we performed a CDS of the cranial and extra-cranial arteries in 93 GCA patients. We observed the halo sign on the FaA, and OcA in 38 (40.9%), and 29 (31.2%) cases, respectively. The FaA, or OcA were affected in 4/22 (18.2%) patients with a negative TA CDS. FaA involvement significantly correlated with jaw claudication and with severe visual manifestations, including permanent visual loss.
A fifth of patients with a negative CDS of the TAs had signs of vasculitis on the CDS of the FaA, or OcA. The addition of FaA and OcA CDS to the routine CDS of the TAs could identify 4.3% more patients and thus further improve the sensitivity of the CDS in the suspected GCA.
彩色多谱勒超声（CDS）在巨细胞动脉炎（GCA）中可用于研究除颞动脉外其他不方便活检的颅动脉受累情况，如面动脉（FaA）和枕动脉（OcA）。我们旨在评估 FaA 和 OcA 在 GCA 中的受累频率，并探讨这些亚组患者的临床特征。
从 2014 年 1 月 1 日至 2016 年 12 月 31 日，我们前瞻性地对所有新诊断为疑似 GCA 的患者进行 CDS 检查，包括颞动脉（TA）以及颅外锁骨下动脉，同时检查 FaA 和 OcA。所有动脉均在两个平面上进行评估，以观察高度特异性的 halo 征。
在 36 个月的观察期内，我们对 93 例 GCA 患者进行了颅内外动脉的 CDS 检查。我们观察到 FaA 和 OcA 上的 halo 征分别在 38 例（40.9%）和 29 例（31.2%）患者中出现。4/22（18.2%）TA CDS 阴性的患者存在 FaA 或 OcA 受累。FaA 受累与颌跛行和严重的视觉表现，包括永久性视力丧失显著相关。
TA CDS 阴性的患者中有五分之一在 FaA 或 OcA 的 CDS 上有血管炎的迹象。将 FaA 和 OcA 的 CDS 添加到常规的 TA CDS 中，可以发现多 4.3%的患者，从而进一步提高 CDS 在疑似 GCA 中的敏感性。
