From the University Hospital Bonn III, Medical Clinic, Department of Oncology, Hematology and Rheumatology, Bonn; Immanuel Krankenhaus Berlin, Medical Center for Rheumatology Berlin-Buch, Berlin; Asklepios Medical Center, Bad Abbach, Germany; Hospital of Southwest Denmark, Esbjerg; Diagnostic Centre Region Hospital Silkeborg, Silkeborg; Odense University Hospital, Odense; Copenhagen Center for Arthritis Research (COPECARE), Glostrup, Denmark; Medical University Graz, Graz; Medical University Innsbruck, Innsbruck, Austria; Hospital of Bruneck, Bruneck; Università degli Studi di Torino, Turin; Epidemiology Unit - Italian Society for Rheumatology (SIR), Milan; Arcispedale Santa Maria Nuova, Reggio Emilia; University of Ferrara, Italy; MC Groep Hospitals, Lelystad; Leiden University Medical Center, the Netherlands; Hôpital Ambroise Paré, Boulogne-Billancourt, France; University Hospital La Paz, Madrid, Spain; Martina Hansens Hospital, Bærum, Oslo, Norway; University Medical Centre Ljubljana, Ljubljana, Slovenia; University of California at Los Angeles, Los Angeles, California; Mayo Clinic, Rochester, Minnesota, USA; Pomeranian Medical University, Szczecin, Poland; Norfolk and Norwich University Hospital, Norwich; Southend University Hospital, UK National Health Service (NHS) Foundation Trust and Anglia Ruskin University, Westcliff, UK; Rheumatology Research Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon; Rheumatology Department, Hospital de Santa Maria - CHLN, Lisbon, Portugal.
V.S. Schäfer, MD, University Hospital Bonn III, Medical Clinic, Department of Oncology, Hematology and Rheumatology, and Immanuel Krankenhaus Berlin, Medical Center for Rheumatology Berlin-Buch; S. Chrysidis, MD, Hospital of Southwest Denmark; C. Dejaco, MD, PhD, Medical University Graz, and Hospital of Bruneck; C. Duftner, MD, PhD, Medical University Innsbruck; A. Iagnocco, MD, Università degli Studi di Torino; G.A. Bruyn, MD, PhD, MC Groep Hospitals; G. Carrara, MSc, Epidemiology Unit - SIR; M.A. D'Agostino, MD, PhD, Hôpital Ambroise Paré; E. De Miguel, MD, University Hospital La Paz; A.P. Diamantopoulos, MD, PhD, MPH, Martina Hansens Hospital; U. Fredberg, MD, PhD, Diagnostic Centre Region Hospital Silkeborg, and Odense University Hospital; W. Hartung, MD, Asklepios Medical Center; A. Hocevar, MD, MSc, University Medical Centre Ljubljana; A. Juche, MD, Immanuel Krankenhaus Berlin, Medical Center for Rheumatology Berlin-Buch; T.A. Kermani, MD, University of California at Los Angeles; M.J. Koster, MD, Mayo Clinic; T. Lorenzen, MD, Diagnostic Centre Region Hospital Silkeborg; P. Macchioni, MD, Arcispedale Santa Maria Nuova; M. Milchert, MD, PhD, Pomeranian Medical University; U.M. Døhn, MD, PhD, COPECARE; C. Mukhtyar, MBBS, MSc, MD, Norfolk and Norwich University Hospital; C. Ponte, MD, Rheumatology Research Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, and Rheumatology Department, Hospital de Santa Maria - CHLN; S. Ramiro, MD, MSc, PhD, Leiden University Medical Center; C.A. Scirè, MD, PhD, Epidemiology Unit - SIR, and University of Ferrara; L. Terslev, MD, PhD, COPECARE; K.J. Warrington, MD, Mayo Clinic; B. Dasgupta, MBBS, MD, FRCP, Southend University Hospital, NHS Foundation Trust and Anglia Ruskin University; W.A. Schmidt, MD, Immanuel Krankenhaus Berlin, Medical Center for Rheumatology Berlin-Buch.
J Rheumatol. 2018 Aug;45(9):1289-1295. doi: 10.3899/jrheum.171428. Epub 2018 Jul 1.
To test the reliability of Outcome Measures in Rheumatology Clinical Trials (OMERACT) consensus-based ultrasound definitions for normal and vasculitic temporal and axillary arteries in patients with giant cell arteritis (GCA) and in controls.
A preliminary 1-day meeting and a full 3-day meeting fulfilling OMERACT Ultrasound Group guidelines were held. Temporal and axillary arteries were examined at 2 timepoints by 12 sonographers on 4 patients with GCA and 2 controls. The aim was to test inter- and intrareader reliability for normal findings, halo sign, and compression sign. In both meetings, patients had established GCA. Pathology was more recent in the full meeting, which was preceded by 6 h of training. Scanning time was 15-20 min instead of 10-13 min.
In the preliminary exercise, interreader reliabilities were fair to moderate for the overall diagnosis of GCA (Light κ 0.29-0.51), and poor to fair for identifying vasculitis in the respective anatomical segments (Light κ 0.02-0.46). Intrareader reliabilities were moderate (Cohen κ 0.32-0.64). In the main exercise, interreader reliability was good to excellent (Light κ 0.76-0.86) for the overall diagnosis of GCA, and moderate to good (Light κ 0.46-0.71) for identifying vasculitis in the respective anatomical segments. Intrareader reliability was excellent for diagnosis of GCA (Cohen κ 0.91) and good (Cohen κ 0.71-0.80) for the anatomical segments.
OMERACT-derived definitions of halo and compression signs of temporal and axillary arteries are reliable in recent-onset GCA if experienced sonographers (> 300 examinations) have 15-20 min for a standardized examination with prior training and apply > 15 MHz probes.
测试基于 OMERACT 共识的超声定义在巨细胞动脉炎（GCA）患者和对照者正常和血管炎性颞动脉和腋动脉中的可靠性。
进行了为期 1 天的预备会议和为期 3 天的完整会议，以满足 OMERACT 超声小组的准则。由 12 名超声医师在 4 名 GCA 患者和 2 名对照者的 2 个时间点对颞动脉和腋动脉进行检查。目的是测试正常发现、晕环征和压迫征的观察者内和观察者间可靠性。在两次会议中，患者均患有确诊的 GCA。在完整会议之前，进行了 6 小时的培训，病理更为近期。扫描时间为 15-20 分钟，而不是 10-13 分钟。
在初步研究中，整体 GCA 诊断的观察者间可靠性为中等至较好（Light κ 0.29-0.51），而相应解剖部位血管炎的识别可靠性为差至中等（Light κ 0.02-0.46）。观察者内可靠性为中等（Cohen κ 0.32-0.64）。在主要研究中，整体 GCA 诊断的观察者间可靠性为好至极好（Light κ 0.76-0.86），相应解剖部位血管炎的识别可靠性为中至好（Light κ 0.46-0.71）。GCA 诊断的观察者内可靠性为极好（Cohen κ 0.91），而解剖部位的可靠性为好（Cohen κ 0.71-0.80）。
如果经验丰富的超声医师（>300 次检查）有 15-20 分钟的时间进行标准化检查，且使用>15MHz 探头，并进行了预先培训，那么基于 OMERACT 的颞动脉和腋动脉晕环征和压迫征的定义在新发 GCA 中是可靠的。
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