Background/Purpose:

The Colour-Doppler Sonography of temporal arteries (CDS-TA) has recently gained momentum as a potential non-invasive tool for diagnosing GCA. Our aim was to evaluate the diagnostic value of CDS-TA in suspected GCA cases in daily clinical practice.

Methods: Subjects with suspected GCA underwent CDS-TA prior to temporal artery biopsy (TAB). CDS-TA was performed on a Philips IU22 using a 5–17.5 MHz linear probe. TA were assessed in longitudinal and transversal planes. The “halo sign” (dark hypo echoic circumferential wall thickening), stenosis or occlusion were considered a positive finding. In addition to CDS-TA, clinical examination, extensive laboratory work-up, and TAB were performed. Diagnosis was established in accordance with the American College of Rheumatology (ACR) criteria. 

Results: From 1.9.2011 to 31.5.2015 (45 months) 139 subjects with suspected GCA were identified. GCA was diagnosed in 96/139 (69.1%). The remaining 43/139 (30.9%) who were not diagnosed with GCA served as controls. CDS-TA was performed in 138/139 subjects (95/96 GCA patients and in 43/43 controls). The “halo sign” was observed in 74 (77.9%) of GCA patients and in none of the controls. The “halo sign” was unilateral in 28/74 (37.8%) and bilateral in 46/74 of GCA patients. Stenoses were found in 41/95 (43.1%) of GCA patients and in 2/43 (4.7%) controls. TA occlusion was demonstrated in 13/95 (13.7%) of GCA patients and in none of the controls. In our population the CDS-TA had an estimated diagnostic sensitivity of 77.9% and specificity of 95.4% with diagnosis based on the ACR criteria serving as a gold standard. A positive CDS-TA had 97.4% positive and 66.1% negative predictive value for GCA. The TAB for the same group had a diagnostic sensitivity of 80.0% and specificity of 90.3%; and a 95.5% positive and a 63.6% negative predictive value. There was an 80% matching of CDS-TA and TAB (Table 1).

Table 1. Crossmatching of CDS-TA and TAB in suspected GCA

Conclusion:

The diagnostic value of CDS-TA for diagnosing GCA is comparable, if not superior to TAB. In case of characteristic sonographic changes, CDS-TA may obviate the need for TAB.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-performance-of-colour-doppler-sonography-of-temporal-arteries-in-patients-suspect-of-having-giant-cell-arteritis-in-daily-clinical-practice/