Color-coded sonography in suspected temporal arteritis-experiences after 83 cases
- PMID: 14600785
- DOI: 10.1007/s00296-003-0372-6
Color-coded sonography in suspected temporal arteritis-experiences after 83 cases
Abstract
Color-coded sonography is an interesting option for the diagnosis of temporal arteritis. We present our experiences regarding examination technique and diagnostic accuracy, comparing biopsy and clinical results in a series of 83 patients with suspected temporal arteritis. A dark halo around the vessel wall (representing inflammatory oedema), reduced or absent vessel wall pulsations (demonstrated by M mode), and vessel occlusions were used as diagnostic criteria. Forty-eight patients underwent biopsy of the temporal artery following ultrasound examination. Comparing these findings with biopsy yielded a sensitivity of 73%, specificity of 93%, positive predictive value (PPV) of 96%, and negative predictive value (NPV) of 58%. The halo sign alone had a lower sensitivity (67%). Comparison with overall clinical assessment (n = 83) yielded a sensitivity of 65%, specificity of 100%, PPV of 100%, and NPV of 73%. Irregular atherosclerotic vessel wall changes were the main differential diagnosis. Important pitfalls were false focus setting, too much/less color gain, and 'bifurcation halo'. In conclusion, a positive sonographic result in combination with typical clinical signs might replace the need for biopsy, while a negative result should not be used for exclusion of temporal arteritis. Considering the low PPV and high NPV of the clinical criteria defined by the American College of Rheumatology, color-coded sonography is a useful tool in the noninvasive diagnostic workup of temporal arteritis.
Similar articles
-
The predictive value of the halo sign in color Doppler ultrasonography of the temporal arteries for diagnosing giant cell arteritis.J Rheumatol. 2002 Jun;29(6):1224-6. J Rheumatol. 2002. PMID: 12064840
-
[Use of high resolution color Doppler sonography in diagnosis of temporal arteritis].Rofo. 1998 Dec;169(6):605-8. doi: 10.1055/s-2007-1015349. Rofo. 1998. PMID: 9930213 German.
-
The utility of color duplex ultrasonography in the diagnosis of temporal arteritis.J Vasc Surg. 2002 Dec;36(6):1154-60. doi: 10.1067/mva.2002.129648. J Vasc Surg. 2002. PMID: 12469046
-
The role of ultrasound in the diagnosis and follow-up of large-vessel vasculitis: an update.Clin Exp Rheumatol. 2017 Mar-Apr;35 Suppl 103(1):194-198. Epub 2017 Mar 29. Clin Exp Rheumatol. 2017. PMID: 28375834 Review.
-
Doppler ultrasonography in the diagnosis of giant cell arteritis.Clin Exp Rheumatol. 2000 Jul-Aug;18(4 Suppl 20):S40-2. Clin Exp Rheumatol. 2000. PMID: 10948760 Review.
Cited by
-
Diagnostic value of high-resolution MR imaging in giant cell arteritis.AJNR Am J Neuroradiol. 2007 Oct;28(9):1722-7. doi: 10.3174/ajnr.A0638. Epub 2007 Sep 20. AJNR Am J Neuroradiol. 2007. PMID: 17885247 Free PMC article.
-
Multi-Modality Imaging in Vasculitis.Diagnostics (Basel). 2024 Apr 18;14(8):838. doi: 10.3390/diagnostics14080838. Diagnostics (Basel). 2024. PMID: 38667483 Free PMC article. Review.
-
Role of the halo sign in the assessment of giant cell arteritis: a systematic review and meta-analysis.Rheumatol Adv Pract. 2021 Aug 19;5(3):rkab059. doi: 10.1093/rap/rkab059. eCollection 2021. Rheumatol Adv Pract. 2021. PMID: 34514295 Free PMC article.
-
EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice summary.Radiol Med. 2019 Oct;124(10):965-972. doi: 10.1007/s11547-019-01058-0. Epub 2019 Jun 28. Radiol Med. 2019. PMID: 31254221 Review.
-
Color duplex ultrasonography of temporal arteries: role in diagnosis and follow-up of suspected cases of temporal arteritis.Clin Rheumatol. 2012 Feb;31(2):231-7. doi: 10.1007/s10067-011-1808-0. Epub 2011 Jul 9. Clin Rheumatol. 2012. PMID: 21743987
References
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical