Karl Pfadenhauer1, Hermann Weber. 1. Department of Neurology, Klinikum Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany. neurologie@klinikum-augsburg.de
Abstract
OBJECTIVE: Evaluation of the diagnostic contribution of color coded duplex sonography (CCDS) of the superficial temporal (STA) and the occipital artery (OCCA) in biopsy-controlled patients suspected of having temporal arteritis (TA). METHODS: Prospective study in 67 patients suspected of having TA who underwent CCDS of the STA in all cases and the occipital arteries if involvement of the OCCA was suspected clinically. The final diagnosis, based on biopsy results in 67 cases and standard criteria, were compared to the ultrasonographic findings to determine their diagnostic contribution. RESULTS: TA was diagnosed in 40 patients, other diseases in 27 patients. In the STA periarterial hypoechogenic tissue, the so-called halo, halo and stenoses, and occlusions were found in 83% of TA patients and 11% of patients with other diseases. In the OCCA, these abnormalities were found in 65% of TA patients and in no patient with other diseases. Taking both STA and OCCA together, halo, stenosis, and widespread abnormalities were found in patients with TA, but not in patients with other diseases. CONCLUSION: CCDS of the STA and OCCA clearly contributes to the diagnosis of TA, with a high rate of perivascular hypoechogenic abnormalities (so-called halos) and stenosis and a low rate of these abnormalities in the control patients. However, CCDS cannot differentiate between inflammatory and degenerative artery disease and has spatial resolution limitations.
OBJECTIVE: Evaluation of the diagnostic contribution of color coded duplex sonography (CCDS) of the superficial temporal (STA) and the occipital artery (OCCA) in biopsy-controlled patients suspected of having temporal arteritis (TA). METHODS: Prospective study in 67 patients suspected of having TA who underwent CCDS of the STA in all cases and the occipital arteries if involvement of the OCCA was suspected clinically. The final diagnosis, based on biopsy results in 67 cases and standard criteria, were compared to the ultrasonographic findings to determine their diagnostic contribution. RESULTS: TA was diagnosed in 40 patients, other diseases in 27 patients. In the STA periarterial hypoechogenic tissue, the so-called halo, halo and stenoses, and occlusions were found in 83% of TA patients and 11% of patients with other diseases. In the OCCA, these abnormalities were found in 65% of TA patients and in no patient with other diseases. Taking both STA and OCCA together, halo, stenosis, and widespread abnormalities were found in patients with TA, but not in patients with other diseases. CONCLUSION: CCDS of the STA and OCCA clearly contributes to the diagnosis of TA, with a high rate of perivascular hypoechogenic abnormalities (so-called halos) and stenosis and a low rate of these abnormalities in the control patients. However, CCDS cannot differentiate between inflammatory and degenerative artery disease and has spatial resolution limitations.
Authors: Julia A Ford; Michael A DiIorio; Weixing Huang; Piotr Sobiesczcyk; William P Docken; Sara K Tedeschi Journal: Clin Exp Rheumatol Date: 2020-04-27 Impact factor: 4.473