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Diagnosis

 

B-mode sonography wall thickness assessment of the temporal and axillary arteries for the diagnosis of giant cell arteritis: a cohort study

1, 2, 3, 4, 5, 6, 7, 8, 9

 

  1. Division of Vascular Medicine, Medical Clinic and Policlinic IV, Hospital of the Ludwig-Maximilians-University, Munich, Germany. michael.czihal@med.uni-muenchen.de
  2. Division of Vascular Medicine, Medical Clinic and Policlinic IV, Hospital of the Ludwig-Maximilians-University, Munich, Germany.
  3. Division of Vascular Medicine, Medical Clinic and Policlinic IV, Hospital of the Ludwig-Maximilians-University, Munich, Germany.
  4. Division of Vascular Medicine, Medical Clinic and Policlinic IV, Hospital of the Ludwig-Maximilians-University, Munich, Germany.
  5. Division of Rheumatology, Medical Clinic and Policlinic IV, Hospital of the Ludwig-Maximilians-University, Munich, Germany.
  6. Institute of Clinical Radiology, Hospital of the Ludwig-Maximilians-University, Munich, Germany.
  7. Institute of Clinical Radiology, Hospital of the Ludwig-Maximilians-University, Munich, Germany.
  8. Division of Rheumatology, Medical Clinic and Policlinic IV, Hospital of the Ludwig-Maximilians-University, Munich, Germany.
  9. Division of Vascular Medicine, Medical Clinic and Policlinic IV, Hospital of the Ludwig-Maximilians-University, Munich, Germany.

CER10254
2017 Vol.35, N°1 ,Suppl.103
PI 0128, PF 0133
Diagnosis

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PMID: 28375835 [PubMed]

Received: 13/01/2017
Accepted : 09/03/2017
In Press: 04/04/2017
Published: 20/04/2017

Abstract

OBJECTIVES:
We aimed to determine the diagnostic accuracy of B-mode compression sonography of the temporal arteries (tempCS) and B-mode sonographic measurement of the axillary artery intima media thickness (axIMT) for the diagnosis of giant cell arteritis (GCA).
METHODS:
After having established measurement of tempCS and axIMT in our routine diagnostic workup, 92 consecutive patients with a suspected diagnosis of GCA were investigated. Clinical characteristics were recorded and wall thickening of the temporal arteries (tempCS) and axillary arteries (axIMT) was measured (mm). Using the final clinical diagnosis as the reference standard, receiver operator characteristics (ROC) analysis was performed. In a subgroup of 26 patients interobserver agreement was assessed using Spearman’s rank correlation.
RESULTS:
Cranial GCA, extracranial GCA, and combined cranial/extracranial GCA were diagnosed in 18, 7, and 9 individuals, respectively. For the diagnosis of cranial GCA, tempCS had an excellent area under the curve (AUC) of 0.95, with a cut-off of ≥0.7 mm offering a sensitivity and specificity of 85% and 95%. The AUC of axIMT for the diagnosis of extracranial GCA was 0.91 (cut-off ≥1.2 mm: sensitivity and specificity 81.3 and 96.1%). Applying a combined tempCS/axIMT cut-off of ≥0.7mm/1.2 mm, we calculated an overall sensitivity and specificity for the final clinical diagnosis of cranial and/or extracranial GCA of 85.3% and 91.4%. Interobserver agreement was strong for both parameters assessed (Spearman’s rho 0.72 and 0.77, respectively).
CONCLUSIONS:
The combination of tempCS/axIMT allows objective sonographic assessment in suspected GCA with promising diagnostic accuracy.

Rheumatology Article