Chrysidis Stavros, Duftner Christina, Dejaco Christian, Schäfer Valentin S, Ramiro Sofia, Carrara Greta, Scirè Carlo Alberto, Hocevar Alojzija, Diamantopoulos Andreas P, Iagnocco Annamaria, Mukhtyar Chetan, Ponte Cristina, Naredo Esperanza, De Miguel Eugenio, Bruyn George A, Warrington Kenneth J, Terslev Lene, Milchert Marcin, D'Agostino Maria Antonietta, Koster Mattew J, Rastalsky Naina, Hanova Petra, Macchioni Pierluigi, Kermani Tanaz A, Lorenzen Tove, Døhn Uffe Møller, Fredberg Ulrich, Hartung Wolfgang, Dasgupta Bhaskar, Schmidt Wolfgang A
Department of Rheumatology, Hospital of Southwest Jutland, Esbjerg, Denmark.
Department of Internal Medicine, Clinical Division of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
RMD Open. 2018 May 17;4(1):e000598. doi: 10.1136/rmdopen-2017-000598. eCollection 2018.
To define the elementary ultrasound (US) lesions in giant cell arteritis (GCA) and to evaluate the reliability of the assessment of US lesions according to these definitions in a web-based reliability exercise.
Potential definitions of normal and abnormal US findings of temporal and extracranial large arteries were retrieved by a systematic literature review. As a subsequent step, a structured Delphi exercise was conducted involving an expert panel of the Outcome Measures in Rheumatology (OMERACT) US Large Vessel Vasculitis Group to agree definitions of normal US appearance and key elementary US lesions of vasculitis of temporal and extracranial large arteries. The reliability of these definitions on normal and abnormal blood vessels was tested on 150 still images and videos in a web-based reliability exercise.
Twenty-four experts participated in both Delphi rounds. From originally 25 statements, nine definitions were obtained for normal appearance, vasculitis and arteriosclerosis of cranial and extracranial vessels. The 'halo' and 'compression' signs were the key US lesions in GCA. The reliability of the definitions for normal temporal and axillary arteries, the 'halo' sign and the 'compression' sign was excellent with inter-rater agreements of 91-99% and mean kappa values of 0.83-0.98 for both inter-rater and intra-rater reliabilities of all 25 experts.
The 'halo' and the 'compression' signs are regarded as the most important US abnormalities for GCA. The inter-rater and intra-rater agreement of the new OMERACT definitions for US lesions in GCA was excellent.
明确巨细胞动脉炎（GCA）的基本超声（US）病变，并在一项基于网络的可靠性评估中，根据这些定义评估US病变评估的可靠性。
通过系统的文献综述检索颞动脉和颅外大动脉正常及异常US表现的潜在定义。随后，开展了一项结构化的德尔菲评估，参与的专家小组来自风湿病结局评估（OMERACT）US大血管血管炎组，目的是就颞动脉和颅外大动脉血管炎的正常US表现及关键基本US病变的定义达成一致。在一项基于网络的可靠性评估中，对150张静态图像和视频测试了这些关于正常和异常血管定义的可靠性。
24名专家参与了两轮德尔菲评估。从最初的25条陈述中，获得了关于颅内外血管正常表现、血管炎和动脉硬化的9条定义。“晕征”和“压迫征”是GCA的关键US病变。正常颞动脉和腋动脉、“晕征”和“压迫征”定义的可靠性极佳，所有25名专家的评分者间一致性为91%-99%，评分者间及评分者内可靠性的平均kappa值为0.83-0.98。
“晕征”和“压迫征”被视为GCA最重要的US异常表现。新的OMERACT关于GCA中US病变的定义在评分者间和评分者内的一致性极佳。
