Lauwerys B R, Puttemans T, Houssiau F A, Devogelaer J P
Department of Rheumatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
J Rheumatol. 1997 Aug;24(8):1570-4.
To test the diagnostic value of color Doppler sonography (CDS) of the superficial temporal arteries in patients suffering from giant cell arteritis (GCA).
The superficial temporal arteries and their frontal and parietal rami were examined by CDS in 11 patients with GCA, 21 patients with polymyalgia rheumatica (PMR), and 32 controls. The peak systolic velocity (Vmax) was measured at the tragus (proximal superficial temporal artery) and at the temporal bone (distal superficial temporal artery) level. Hypoechoic thickening of the vessel wall was systematically searched for.
Mean Vmax in the proximal and distal superficial temporal artery was considerably lower in the GCA group [mean (+/- SEM) 30.9 (+/- 5.6) mm/s proximally and 5.8 (+/- 3.7) mm/s distally] compared to the PMR group [mean (+/- SEM) 64.6 (+/- 3.8) mm/s proximally and 49.3 (+/- 4.2) mm/s distally] and the control group [mean (+/- SEM) 56.9 (+/- 2.2) mm/s proximally and 42.6 (+/- 2.2) distally]. Thickening of the vessel wall was found in only 2 patients: one with GCA and one with PMR. Followup of CDS in 6 GCA patients under treatment produced evidence of a significant increase in the mean Vmax at the distal site.
Decreased blood flow velocity in the superficial temporal artery is very common in GCA patients and rare in PMR patients. Therefore, CDS examination may contribute to the diagnosis of GCA.
检测彩色多普勒超声(CDS)对颞浅动脉在巨细胞动脉炎(GCA)患者中的诊断价值。
对11例GCA患者、21例风湿性多肌痛(PMR)患者和32例对照者进行颞浅动脉及其额支和顶支的CDS检查。在耳屏(颞浅动脉近端)和颞骨(颞浅动脉远端)水平测量收缩期峰值流速(Vmax)。系统地寻找血管壁的低回声增厚。
与PMR组[近端平均(±标准误)64.6(±3.8)mm/s,远端平均(±标准误)49.3(±4.2)mm/s]和对照组[近端平均(±标准误)56.9(±2.2)mm/s,远端平均(±标准误)42.6(±2.2)mm/s]相比,GCA组颞浅动脉近端和远端的平均Vmax显著降低[近端平均(±标准误)30.9(±5.6)mm/s,远端平均(±标准误)5.8(±3.7)mm/s]。仅在2例患者中发现血管壁增厚:1例GCA患者和1例PMR患者。对6例接受治疗的GCA患者进行CDS随访,结果显示远端部位的平均Vmax显著增加。
颞浅动脉血流速度降低在GCA患者中非常常见,而在PMR患者中罕见。因此,CDS检查可能有助于GCA的诊断。