Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
Rheumatology (Oxford). 2021 Mar 2;60(3):1346-1352. doi: 10.1093/rheumatology/keaa578.
Colour Doppler sonography (CDS) is becoming ever more important in the diagnosis of GCA. Data on cut-off values for intima-media complex thickness (IMT) that can be used in clinical practice to distinguish between normal and inflamed arteries are limited. We aimed to derive potential cut-off values for IMT of seven preselected arteries by comparing IMT between GCA patients and a control group.
We performed CDS of the preselected temporal, facial, occipital, carotid, vertebral, subclavian and axillary arteries in consecutive newly diagnosed GCA patients between October 2013 and September 2019. A 'halo' with positive compression sign was considered a positive finding. We measured the maximum IMT in the preselected arteries and compared it with the maximum IMT of the control group.
We were able to demonstrate a halo sign in at least one of the examined arteries of 244/248 (98.4%) GCA patients. Temporal arteries were the most commonly affected vessels, involved in 192 (77.4%) patients. We found extracranial large vessel involvement in 87 (35.1%) patients. The following cut-off values showed high levels of diagnostic accuracy: ≥0.4 mm for temporal, facial and occipital arteries, ≥0.7 mm for vertebral arteries, and ≥1 mm for carotid, subclavian and axillary arteries.
The involvement of a large array of arteries is easily and commonly detected by CDS and provides a high diagnostic yield in patients with suspected GCA. Proposed IMT cut-off values might further improve the diagnostic utility of CDS in these patients.
彩色多谱勒超声（CDS）在巨细胞动脉炎（GCA）的诊断中变得越来越重要。用于区分正常和炎症动脉的内-中膜复合体厚度（IMT）的临界值数据在临床上有限。我们旨在通过比较 GCA 患者和对照组之间的 IMT，为 7 条预选动脉的 IMT 获得潜在的临界值。
我们对 2013 年 10 月至 2019 年 9 月期间连续诊断的新 GCA 患者进行了预选颞、面、枕、颈、椎动脉、锁骨下动脉和腋动脉的 CDS。有阳性压迫征的“晕环”被认为是阳性发现。我们测量了预选动脉中的最大 IMT，并将其与对照组的最大 IMT 进行了比较。
我们能够在 244/248（98.4%）GCA 患者的至少一条检查动脉中显示晕环征。颞动脉是最常受影响的血管，受累 192 例（77.4%）患者。我们发现 87 例（35.1%）患者存在颅外大血管受累。以下临界值具有较高的诊断准确性：颞、面、枕动脉的≥0.4mm，椎动脉的≥0.7mm，颈、锁骨下和腋动脉的≥1mm。
通过 CDS 很容易且通常可以检测到大量动脉受累，为疑似 GCA 的患者提供了较高的诊断率。建议的 IMT 临界值可能会进一步提高 CDS 在这些患者中的诊断效用。
