From the Department of Radiology and Department of Rheumatology, St. Vincent's University Hospital, Elm Park, Dublin, Ireland.
Stroke. 2018 Sep;49(9):2233-2236. doi: 10.1161/STROKEAHA.118.021995.
Background and Purpose- The diagnosis of giant-cell arteritis (GCA) is challenging. Superficial temporal artery biopsy and ultrasound are positive in only 50%. We evaluated computed tomographic angiography (CTA) of the head in GCA. Methods- This case-control study was performed using a prospective GCA registry. Cases presented with stroke symptoms, had a CTA, and were subsequently diagnosed with GCA. Age- and sex-matched controls presented with stroke symptoms, had a CTA, and were not diagnosed with GCA. CTAs were evaluated for the presence of superficial temporal artery abnormalities. Results- Fourteen cases met the inclusion criteria and were matched with 14 controls. Blurred vessel wall margins and perivascular enhancement was found in 10 cases (71.4%) and 2 controls (14.3%). CTA has an accuracy of 78.6%, sensitivity of 71.4%, and a specificity of 85.7% for GCA. Conclusions- CTA detects superficial temporal artery abnormalities in GCA. This may facilitate early diagnosis and prompt implementation of potentially sight-saving and stroke-preventing treatment.
背景与目的-巨细胞动脉炎（GCA）的诊断具有挑战性。颞浅动脉活检和超声检查的阳性率仅为 50%。我们评估了头颈部计算机断层血管造影（CTA）在 GCA 中的应用。方法-这项病例对照研究使用了前瞻性 GCA 登记处。病例组表现为卒中症状，行 CTA 检查，随后诊断为 GCA。对照组表现为卒中症状，行 CTA 检查，未诊断为 GCA，且与病例组年龄和性别匹配。评估 CTA 是否存在颞浅动脉异常。结果-符合纳入标准的 14 例病例与 14 例对照组相匹配。10 例（71.4%）病例和 2 例对照组（14.3%）存在血管壁边缘模糊和血管周围强化。CTA 对 GCA 的诊断准确性为 78.6%，敏感性为 71.4%，特异性为 85.7%。结论-CTA 可检测 GCA 中的颞浅动脉异常。这可能有助于早期诊断和及时实施潜在的保护视力和预防卒中的治疗。
