H Wenkel1, G Michelson. 1. Aúgenklinik mit Poliklinik, Universität Erlangen-Nürnberg.
Abstract
BACKGROUND: A biopsy of the temporal arteries is still the appropriate method to prove the diagnosis of giant cell arteritis. We evaluated the potential use of high-resolution ultrasound-biomicroscopy in the diagnosis of giant cell arteritis. PATIENTS AND METHODS: In a prospective study we examined 16 patients (8 women and 8 men) with a mean age of 71 years with the clinical suspicion of a giant cell arteritis. Additionally to the clinical examination the temporal arteries were imaged in all patients using the ultrasound-biomicroscopy (Zeiss-Humphrey Instruments). The results were correlated to the histopathologic changes of the temporal arteries excised bilaterally at the same location. RESULTS: Histopathological evaluation revealed a granulomatous arteritis in 4 out of 16 examined patients. The temporal arteries of these patients also showed characteristic changes using ultrasound biomicroscopy like middle-reflective shadowing of the arterial lumen and a condensation and enlargement of the muscularis media. Ultrasound-biomicroscopy allowed a precise evaluation of the temporal arteries due to a high-resolution sonographic image. The morphological differentiation between a normal and an affected artery was possible. A positive correlation between histopathological and clinical findings was seen in all patients. CONCLUSION: In this preliminary study the ultrasound-biomicroscopy seemed to be an appropriate non-invasive tool for the morphological imaging and evaluation of temporal arteries.
BACKGROUND: A biopsy of the temporal arteries is still the appropriate method to prove the diagnosis of giant cell arteritis. We evaluated the potential use of high-resolution ultrasound-biomicroscopy in the diagnosis of giant cell arteritis. PATIENTS AND METHODS: In a prospective study we examined 16 patients (8 women and 8 men) with a mean age of 71 years with the clinical suspicion of a giant cell arteritis. Additionally to the clinical examination the temporal arteries were imaged in all patients using the ultrasound-biomicroscopy (Zeiss-Humphrey Instruments). The results were correlated to the histopathologic changes of the temporal arteries excised bilaterally at the same location. RESULTS: Histopathological evaluation revealed a granulomatous arteritis in 4 out of 16 examined patients. The temporal arteries of these patients also showed characteristic changes using ultrasound biomicroscopy like middle-reflective shadowing of the arterial lumen and a condensation and enlargement of the muscularis media. Ultrasound-biomicroscopy allowed a precise evaluation of the temporal arteries due to a high-resolution sonographic image. The morphological differentiation between a normal and an affected artery was possible. A positive correlation between histopathological and clinical findings was seen in all patients. CONCLUSION: In this preliminary study the ultrasound-biomicroscopy seemed to be an appropriate non-invasive tool for the morphological imaging and evaluation of temporal arteries.