| Limited value of temporal artery ultrasonography examinations for diagnosis of giant cell arteritis: analysis of 77 subjects. | |
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MedLine Citation:
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PMID: 20810501 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVE: Use of TA-US for diagnostic investigation of giant cell arteritis (GCA) has been proposed but remains a matter of debate because of the heterogeneous findings. We retrospectively evaluated operating characteristics of temporal artery ultrasonography (TA-US) in a single teaching hospital. METHODS: All subjects with suspected GCA had been seen between 2002 and 2008 and had undergone TA-US with continuous-wave Doppler (until 2004) or color duplex ultrasonography (after 2004), followed within 30 days by a temporal artery biopsy (TAB). TA-US findings were compared with TAB-proven GCA and clinically diagnosed GCA. Results are expressed as sensitivities, specificities, and positive (LR+) and negative likelihood ratios (LR-) of stenoses, occlusions, and the halo sign; for the latter, only color duplex TA-US was considered. RESULTS: Seventy-seven patients fulfilled the selection criteria; 13 had TAB-proven and 19 had clinically defined GCA. Stenoses/occlusions were seen on 45.5% of TA-US and the halo sign was seen only once (3.2%) in 31 duplex TA-US. Respective sensitivities, specificities, LR+, and LR- for GCA diagnosis (using TAB-proven/clinically defined GCA as reference standards) were 69%/53%, 59%/57%, 1.7/1.2, and 0.5/0.8 for stenoses and/or occlusions, and 17%/10%, 100%/100%, infinite/infinite, and 0.8/0.9 for the halo sign. CONCLUSION: The halo sign showed 100% specificity for GCA but only 10%-17% sensitivity. Stenoses/occlusions were of low diagnostic value. These observations suggest that TA-US is neither an effective substitute for TAB nor a reliable screening test to decide which patients can be safely spared TAB. |
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Authors:
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Carla Maldini; Caroline Dépinay-Dhellemmes; Thi T S Tra; Michel Chauveau; Yannick Allanore; Laure Gossec; Geneviève Terrasse; Loïc Guillevin; Joël Coste; Alfred Mahr |
Publication Detail:
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Type: Journal Article Date: 2010-09-01 |
Journal Detail:
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Title: The Journal of rheumatology Volume: 37 ISSN: 0315-162X ISO Abbreviation: J. Rheumatol. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7501984 Medline TA: J Rheumatol Country: Canada |
Other Details:
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Languages: eng Pagination: 2326-30 Citation Subset: IM |
Affiliation:
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National Referral Center for Necrotizing Vasculitides and Systemic Sclerosis, Hospital Cochin, Assistance Publique-Hôpitaux de Paris, University Paris 5-René Descartes, Paris, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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