PDF(Pubmed)
Abstract：
OBJECTIVE: In the case of ischemic optic neuropathy (ION) or retinal artery occlusion (RAO), distinguishing arteritic from non-arteritic can limit or prevent irreversible bilateral blindness. Here, the utility of color Doppler ultrasonography (CDUS) in diagnosing giant cell arteritis (GCA) was evaluated.
METHODS: In this retrospective analysis, a total of 38 cases diagnosed with ION or RAO were included, that presented to our department in the years 2018 up to 2021 and underwent both CDUS and temporal artery biopsy (TAB). The evaluation is based on TAB as reference standard.
RESULTS: CDUS resulted in a sensitivity of 65.0% and a specificity of 100% (when excluding two inconclusive assessments). Therefore, when limiting TAB to only suspected cases with negative or unclear CDUS findings, the sensitivity and the specificity would remain unchanged at 100%, while reducing the need for TAB by 42.1%.
CONCLUSIONS: Overall, the data suggest the implementation of a stepwise diagnostic algorithm to confirm or rule out GCA, in which the CDUS plays a key role, thus omitting the requirement for TAB in many cases.
METHODS: In this retrospective analysis, a total of 38 cases diagnosed with ION or RAO were included, that presented to our department in the years 2018 up to 2021 and underwent both CDUS and temporal artery biopsy (TAB). The evaluation is based on TAB as reference standard.
RESULTS: CDUS resulted in a sensitivity of 65.0% and a specificity of 100% (when excluding two inconclusive assessments). Therefore, when limiting TAB to only suspected cases with negative or unclear CDUS findings, the sensitivity and the specificity would remain unchanged at 100%, while reducing the need for TAB by 42.1%.
CONCLUSIONS: Overall, the data suggest the implementation of a stepwise diagnostic algorithm to confirm or rule out GCA, in which the CDUS plays a key role, thus omitting the requirement for TAB in many cases.
摘要：
目的：在缺血性视神经病变（ION）或视网膜动脉阻塞（RAO）的情况下，区分动脉炎和非动脉炎可以限制或预防不可逆的双侧失明.这里,评估了彩色多普勒超声（CDUS）在诊断巨细胞动脉炎（GCA）中的实用性。
方法：在本回顾性分析中，共纳入38例诊断为ION或RAO的病例，在2018年至2021年期间提交给我们部门，并接受了CDUS和颞动脉活检（TAB）。评估基于作为参考标准的TAB。
结果：CDUS的灵敏度为65.0％，特异性为100％（排除两个不确定的评估）。因此,当TAB仅限于CDUS结果阴性或不清楚的可疑病例时，敏感性和特异性保持100%不变，而对TAB的需求减少了42.1%。
结论：总体而言，数据表明实施逐步诊断算法来确认或排除GCA，其中CDUS起着关键作用，因此在许多情况下省略了对TAB的要求。
方法：在本回顾性分析中，共纳入38例诊断为ION或RAO的病例，在2018年至2021年期间提交给我们部门，并接受了CDUS和颞动脉活检（TAB）。评估基于作为参考标准的TAB。
结果：CDUS的灵敏度为65.0％，特异性为100％（排除两个不确定的评估）。因此,当TAB仅限于CDUS结果阴性或不清楚的可疑病例时，敏感性和特异性保持100%不变，而对TAB的需求减少了42.1%。
结论：总体而言，数据表明实施逐步诊断算法来确认或排除GCA，其中CDUS起着关键作用，因此在许多情况下省略了对TAB的要求。
