Ahmed Sara, Fadlelseed Huda, Kennedy Susan, Horgan Noel
Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland.
Department of Histopathology, National Ophthalmic Pathology Laboratory, Royal Victoria Eye and Ear Hospital, Dublin, Ireland.
Ir J Med Sci. 2025 Aug 9. doi: 10.1007/s11845-025-04063-7.
Giant cell arteritis (GCA) is systemic vasculitis affecting medium and large-sized arteries that can result in vision-threatening complications. Temporal artery biopsy (TAB) has long been considered the gold standard method for diagnosing GCA; however, Doppler ultrasound offers a non-invasive alternative.
This study aims to evaluate the accuracy of Doppler ultrasound in comparison to TAB for diagnosing patients with suspected GCA and to determine its impact on treatment decisions.
A retrospective study included 56 participants. They all received a Doppler ultrasound and underwent TAB. The accuracy of Doppler ultrasound was compared against TAB outcomes. The impact of ultrasound on determining the timing of steroid treatment and its correlation with biopsy findings was also evaluated.
Most participants (87%) reported having headaches,73% had vision problems, 60% showed symptoms of Polymyalgia Rheumatica (PMR). Optic nerve inflammation was observed in 71% of cases. Doppler ultrasound demonstrated a sensitivity rate of 70% and a specificity was 53% compared to TAB. Treatment with steroids was commenced for 90% of patients, with the decision often influenced by Doppler results. The timing of steroid treatment did not affect the TAB outcomes. The biopsy results confirmed GCA in 53% of cases, and around 82% of them were classified as active GCA.
While Doppler ultrasound offers a practical alternative, Temporal Artery Biopsy (TAB) is crucial for confirming the diagnosis. Early initiation of steroids guided by clinical and Doppler ultrasound findings is both safe and effective in preventing disease progression and does not impact the biopsy outcome.
巨细胞动脉炎（GCA）是一种影响中、大动脉的系统性血管炎，可导致视力威胁性并发症。颞动脉活检（TAB）长期以来一直被认为是诊断GCA的金标准方法；然而，多普勒超声提供了一种非侵入性替代方法。
本研究旨在评估多普勒超声与TAB相比在诊断疑似GCA患者中的准确性，并确定其对治疗决策的影响。
一项回顾性研究纳入了56名参与者。他们均接受了多普勒超声检查并进行了TAB。将多普勒超声的准确性与TAB结果进行比较。还评估了超声对确定类固醇治疗时机的影响及其与活检结果的相关性。
大多数参与者（87%）报告有头痛症状，73%有视力问题，60%表现出风湿性多肌痛（PMR）症状。71%的病例观察到视神经炎症。与TAB相比，多普勒超声的敏感性为70%，特异性为53%。90%的患者开始使用类固醇治疗，决策通常受多普勒结果影响。类固醇治疗的时机不影响TAB结果。活检结果在53%的病例中确诊为GCA，其中约82%被归类为活动性GCA。
虽然多普勒超声提供了一种实用的替代方法，但颞动脉活检（TAB）对于确诊至关重要。根据临床和多普勒超声检查结果尽早开始使用类固醇在预防疾病进展方面既安全又有效，且不影响活检结果。
