López-Gloria Katerine, Castrejón Isabel, Nieto-González Juan Carlos, Rodríguez-Merlos Pablo, Serrano-Benavente Belén, González Carlos Manuel, Monteagudo Sáez Indalecio, González Teresa, Álvaro-Gracia José María, Molina-Collada Juan
Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
Front Med (Lausanne). 2022 Aug 26;9:981804. doi: 10.3389/fmed.2022.981804. eCollection 2022.
To determine the optimal ultrasound (US) cut-off values for cranial and extracranial arteries intima media thickness (IMT) to discriminate between patients with and without giant cell arteritis (GCA).
Retrospective observational study including patients referred to an US fast-track clinic. All patients underwent bilateral US examination of the cranial and extracranial arteries including the IMT measurement. Clinical confirmation of GCA after 6 months was considered the gold standard for diagnosis. A receiver operating characteristic (ROC) analysis was performed to select the cut-off values on the basis of the best tradeoff values between sensitivity and specificity.
A total of 157 patients were included, 47 (29.9%) with clinical confirmation of GCA after 6 months. 41 (87.2%) of patients with GCA had positive US findings (61.7% had cranial and 44.7% extracranial involvement). The best threshold IMT values were 0.44 mm for the common temporal artery; 0.34 mm for the frontal branch; 0.36 mm for the parietal branch; 1.1 mm for the carotid artery and 1 mm for the subclavian and axillary arteries. The areas under the ROC curves were greater for axillary arteries 0.996 (95% CI 0.991-1), for parietal branch 0.991 (95% CI 0.980-1), for subclavian 0.990 (95% CI 0.979-1), for frontal branch 0.989 (95% CI 0.976-1), for common temporal artery 0.984 (95% CI 0.959-1) and for common carotid arteries 0.977 (95% CI 0.961-0.993).
IMT cut-off values have been identified for each artery. These proposed IMT cut-off values may help to improve the diagnostic accuracy of US in clinical practice.
确定颅内外动脉内膜中层厚度（IMT）的最佳超声（US）临界值，以鉴别巨细胞动脉炎（GCA）患者与非GCA患者。
一项回顾性观察研究，纳入到超声快速诊所就诊的患者。所有患者均接受颅内外动脉的双侧超声检查，包括IMT测量。6个月后GCA的临床确诊被视为诊断的金标准。进行了受试者操作特征（ROC）分析，以根据敏感性和特异性之间的最佳权衡值选择临界值。
共纳入157例患者，47例（29.9%）在6个月后经临床确诊为GCA。41例（87.2%）GCA患者超声检查结果为阳性（61.7%有颅内受累，44.7%有颅外受累）。最佳临界IMT值分别为：颞浅动脉0.44mm；额支0.34mm；顶支0.36mm；颈动脉1.1mm；锁骨下动脉和腋动脉1mm。腋动脉的ROC曲线下面积为0.996（95%CI 0.991-1），顶支为0.991（95%CI 0.980-1），锁骨下动脉为0.990（95%CI 0.979-1），额支为0.989（95%CI 0.976-1），颞浅动脉为0.984（95%CI 0.959-1），颈总动脉为0.977（95%CI 0.961-0.993）。
已确定各动脉的IMT临界值。这些提出的IMT临界值可能有助于提高超声在临床实践中的诊断准确性。
