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The diagnostic utility of intima-media thickness measurement compared with the halo sign in temporal artery ultrasonography: a single-centre retrospective study
K. Yoshida1, R.M. Sada2, A. Yoshioka3, H. Akebo4, H. Miyake5, K. Hatta6
- Department of General Internal Medicine, Tenri Hospital, Nara, and Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
- Department of General Internal Medicine, Tenri Hospital, Nara; Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto; Department of Transformative Protection to Infectious Disease, Graduate School of Medicine, Osaka University, Osaka; and Department of Infection Control, Graduate School of Medicine, Osaka University, Osaka, Japan. sadao@cider.osaka-u.ac.jp
- Department of Clinical Laboratory, Tenri Hospital, Nara, Japan.
- Department of General Internal Medicine, Tenri Hospital, Nara, Japan.
- Department of General Internal Medicine, Tenri Hospital, Nara, Japan.
- Department of General Internal Medicine, Tenri Hospital, Nara, Japan.
CER17735
2025 Vol.43, N°4
PI 0661, PF 0667
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PMID: 39907604 [PubMed]
Received: 01/04/2024
Accepted : 01/08/2024
In Press: 28/01/2025
Published: 08/04/2025
Abstract
OBJECTIVES:
We aimed to examine the diagnostic utility of temporal artery ultrasonography (TAUS) based on measurement of intima-media thickness (IMT) compared with the halo sign in diagnosing cranial giant cell arteritis (GCA).
METHODS:
We retrospectively analysed consecutive patients with clinically suspected GCA who had undergone TAUS between January 2011 and December 2021 in Tenri hospital, Japan. A cut-off value of 0.5 mm was used for the IMT of the temporal arteries. We examined the diagnostic value of TAUS based on each of the halo sign and increased IMT in diagnosing cranial GCA.
RESULTS:
In total, 203 patients were included. Temporal artery biopsy (TAB) was performed in 59 patients, with 32 being biopsy-positive. Fifty-three patients were diagnosed with cranial GCA. The sensitivity and specificity of TAUS based on the increased IMT and halo sign were as follows: sensitivity, 62.3% and 32.1%; specificity, 90.0% and 100% compared with the clinical diagnosis; and sensitivity, 81.2% and 46.9%; specificity, 76.9% and 96.2% compared with the TAB. When the relationship between the IMT and halo sign was evaluated, patients with cranial GCA who presented with the halo sign had the highest IMT compared with those without the halo sign or those without cranial GCA.
CONCLUSIONS:
A TAUS diagnosis relying only on the halo sign is specific but can underestimate cranial GCA. Therefore, evaluation of the IMT in addition to the halo sign can improve the diagnostic accuracy of TAUS when diagnosing cranial GCA.
