Background/Purpose

Ultrasonography (US) of the superficial temporal arteries was introduced in the 1990s. The diagnostic value of US of the superficial temporal artery wall in giant cell arteritis (GCA) has been extensively reported. In order to clarify the effectiveness of US preceding pathological diagnosis, we examined cut-off values of ultrasonography-derived halo signs (intima-media thickness, IMT).

Methods

Twenty-eight patients with suspected GCA were examined by US before biopsy from October 2010 to June 2014, inclusive. US was performed unilaterally or bilaterally by two ultrasonographers and the greatest analyzed. Superficial temporal artery biopsy was used as the reference standard. The Cohen’s Kappa test for Inter-Observer variation was 0.703 (95%CI: 0.390 to 1.015).

Results

Unilateral halo sign had a sensitivity of 83.3 % and specificity of 40.0 %. In ROC analysis, a cut-off of greatest dimension of halo > 0.51 mm was the most accurate for prediction with a sensitivity of 66.7 % and specificity of 80.0 %. The diagnostic odds ratio was 8.0 (95% CI, 1.28 – 50.04).

Conclusion

This is the first report that examined the cut-off values of IMT in diagnosing GCA. The measurement of the greatest dimension of the ultrasonography-derived halo sign (IMT) increased the diagnostic yield for pathological diagnosis.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-cut-off-value-analysis-by-ultrasound-for-the-diagnosis-of-giant-cell-arteritis-gca/