Bosch Philipp, Dejaco Christian, Schmidt Wolfgang A, Schlüter Kenny D-, Pregartner Gudrun, Schäfer Valentin S
Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria.
Medical Centre for Rheumatology Berlin-Buch, Immanuel Krankenhaus Berlin, Berlin, Germany.
Ther Adv Musculoskelet Dis. 2021 Mar 19;13:1759720X21998505. doi: 10.1177/1759720X21998505. eCollection 2021.
To assess intima-media thickness (IMT) changes measured by ultrasound in axillary arteries of giant cell arteritis (GCA) patients over time and to calculate an ultrasound cut-off value for the diagnosis of chronic axillary artery involvement in patients with longstanding GCA.
Ultrasound of both axillary arteries was performed in 109 GCA patients at time of diagnosis and at several follow-up visits and in 40 healthy controls (HCs). IMT determined at the prospective follow-up visit was compared between GCA patients with (axGCA) and without (non-axGCA) vasculitis of axillary arteries at baseline, as well as with HCs. Changes in IMT were depicted. Receiver operating characteristics were performed for cut-off calculations. Inter-/intra-rater agreement was evaluated using stored images and intraclass correlation coefficient (ICC).
Seventy-three patients were in the axGCA and 36 in the non-axGCA group. Pathological IMT of axillary arteries (axGCA) declined in the first 18 months of treatment by -0.5 mm, (range -2.77 to 0.50), independent of age and gender. Median IMT, after median disease duration of 48 months (16-137), was 0.90 mm (0.46-2.20) in axGCA and 0.60 mm (0.42-1.0) in the non-axGCA group pooled with HCs. An IMT of 0.87 mm was highly specific (specificity 96%, sensitivity 61%) for diagnosis of chronic axGCA. Intra-rater and inter-reader agreement of ultrasound images were good [ICC 0.96-1.0 (three readers) and 0.87, respectively].
Pathological IMT of the axillary artery declined under treatment. An IMT of 0.87 mm is highly specific for diagnosis of chronic vasculitis of axillary arteries in long-standing GCA patients.
评估巨细胞动脉炎（GCA）患者腋动脉超声测量的内膜中层厚度（IMT）随时间的变化，并计算用于诊断长期GCA患者慢性腋动脉受累的超声临界值。
对109例GCA患者在诊断时及多次随访时进行双侧腋动脉超声检查，并对40例健康对照者（HCs）进行检查。比较基线时伴有（axGCA）和不伴有（非axGCA）腋动脉血管炎的GCA患者在前瞻性随访时测定的IMT，以及与HCs的IMT。描绘IMT的变化。进行受试者操作特征分析以计算临界值。使用存储的图像和组内相关系数（ICC）评估评分者间/评分者内的一致性。
73例患者属于axGCA组，36例属于非axGCA组。腋动脉（axGCA）的病理性IMT在治疗的前18个月下降了-0.5mm（范围为-2.77至0.50），与年龄和性别无关。在疾病中位持续时间为48个月（16 - 137个月）后，axGCA组的IMT中位数为0.90mm（0.46 - 2.20），非axGCA组与HCs合并后的IMT中位数为0.60mm（0.42 - 1.0）。IMT为0.87mm对慢性axGCA的诊断具有高度特异性（特异性96%，敏感性61%）。超声图像的评分者内和读者间一致性良好[ICC分别为0.96 - 1.0（三位读者）和0.87]。
治疗后腋动脉的病理性IMT下降。IMT为0.87mm对长期GCA患者慢性腋动脉血管炎的诊断具有高度特异性。
