Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Rheumatology.
Rheumatology (Oxford). 2021 Sep 1;60(9):4361-4366. doi: 10.1093/rheumatology/keaa806.
We investigated the relationship between the ultrasonographic Halo Score and temporal artery biopsy (TAB) findings in GCA.
This is a prospective study including 90 patients suspected of having GCA. Ultrasonography of temporal/axillary arteries and a TAB were obtained in all patients at baseline. An experienced pathologist evaluated whether TAB findings were consistent with GCA, and whether transmural inflammation, giant cells and intimal hyperplasia were present. Ultrasonographic Halo Scores were determined. Receiver operating characteristic analysis was performed.
Twenty-seven patients had a positive TAB, while 32 patients with a negative TAB received a clinical diagnosis of GCA after 6 months of follow-up. Patients with a positive TAB showed higher Halo Scores than patients with a negative TAB. The presence of intimal hyperplasia in the biopsy, rather than the presence of transmural inflammation or giant cells, was associated with elevated Halo Scores in patients with GCA. The Halo Score discriminated well between TAB-positive patients with and without intimal hyperplasia, as indicated by an area under the curve of 0.82 in the receiver operating characteristic analysis. Patients with a positive TAB and intimal hyperplasia more frequently presented with ocular ischaemia (40%) than the other patients with GCA (13-14%).
The ultrasonographic Halo Score may help to identify a subset of GCA patients with intimal hyperplasia, a TAB feature associated with ischaemic sight loss.
我们研究了巨细胞动脉炎（GCA）患者的超声 Halo 评分与颞动脉活检（TAB）结果之间的关系。
这是一项前瞻性研究，纳入了 90 例疑似患有 GCA 的患者。所有患者在基线时均进行了颞动脉/腋动脉超声检查和 TAB。一位经验丰富的病理学家评估了 TAB 结果是否与 GCA 一致，以及是否存在壁内炎症、巨细胞和内膜增生。确定了超声 Halo 评分。进行了受试者工作特征分析。
27 例 TAB 阳性患者，32 例 TAB 阴性患者在随访 6 个月后临床诊断为 GCA。TAB 阳性患者的 Halo 评分高于 TAB 阴性患者。活检中存在内膜增生而不是壁内炎症或巨细胞与 GCA 患者的 Halo 评分升高相关。Halo 评分在区分 TAB 阳性且存在内膜增生与不存在内膜增生的患者方面表现良好，受试者工作特征分析的曲线下面积为 0.82。TAB 阳性且存在内膜增生的患者比其他 GCA 患者（13-14%）更常出现眼部缺血（40%）。
超声 Halo 评分可能有助于识别存在内膜增生的 GCA 患者亚组，这是与缺血性视力丧失相关的 TAB 特征。
