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Abstract Number: 1955

The Performance of Colour-Doppler Sonography of Temporal Arteries in Patients Suspect of Having Giant Cell Arteritis in Daily Clinical Practice

Alojzija Hocevar, Rok Ješe, Ziga Rotar and Matija Tomšič, Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Doppler ultrasound, giant cell arteritis and vasculitis

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Session Information

Date: Monday, November 9, 2015

Title: Vasculitis Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

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

Suspected GCA

positive

CDS-TA

negative

CDS-TA

CDS-TA not performed

Total

Positive TAB

54

4

1

59

Inconclusive TAB

4

4

0

8

Negative TAB

10

34

0

44

TAB not done

8

20

0

28

Total

76

62

1

 

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.


Disclosure: A. Hocevar, None; R. Ješe, None; Z. Rotar, None; M. Tomšič, None.

To cite this abstract in AMA style:

Hocevar A, Ješe R, Rotar Z, Tomšič M. The Performance of Colour-Doppler Sonography of Temporal Arteries in Patients Suspect of Having Giant Cell Arteritis in Daily Clinical Practice [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). 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/. Accessed .
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