Abstract：
OBJECTIVE: To assess the diagnostic value for GCA in adding the axillary arteries (AX) to the temporal artery (TA) ultrasound, particularly in patients with a cranial phenotype of the disease; and to investigate the utility of facial (FA), occipital (OC), subclavian (SC), and common carotid (CC) ultrasound in patients with suspected GCA.
METHODS: Patients with new-onset GCA and a positive ultrasound of the TA, AX, FA, OC, SC or CC, followed at the rheumatology departments of two academic centres, were retrospectively included.
RESULTS: 230 patients were assessed. TA halo sign was identified in 206/230 (89.6%) cases, FA in 40/82 (48.8%), OC in 17/69 (24.6%), AX in 56/230 (24.3%), SC in 31/57 (54.4%), and CC in 14/68 (20.6%). Negative TA ultrasound was found in 24/230 (10.4%) patients: 22 had AX involvement, 1 exclusive OC involvement and 1 exclusive SC involvement. Adding AX evaluation to the TA ultrasound increased the diagnostic yield for GCA in 9.6%, whereas adding OC or SCs to the TA and AX ultrasound increased it in 1.4% and 1.8%, respectively. No value was found in adding the FA or CCs. Notably, 13 patients with cranial symptoms and 4 with exclusively cranial symptoms showed negative TA ultrasound but positive AX ultrasound.
CONCLUSIONS: Adding the evaluation of AXs to the TA ultrasound increased the number of patients diagnosed with GCA, even in cases of predominantly cranial symptoms. In the subset of patients where these arteries were assessed, no substantial benefit was found in adding the FA, OC, SC or CC arteries to the TA and AX ultrasonographic assessment.
METHODS: Patients with new-onset GCA and a positive ultrasound of the TA, AX, FA, OC, SC or CC, followed at the rheumatology departments of two academic centres, were retrospectively included.
RESULTS: 230 patients were assessed. TA halo sign was identified in 206/230 (89.6%) cases, FA in 40/82 (48.8%), OC in 17/69 (24.6%), AX in 56/230 (24.3%), SC in 31/57 (54.4%), and CC in 14/68 (20.6%). Negative TA ultrasound was found in 24/230 (10.4%) patients: 22 had AX involvement, 1 exclusive OC involvement and 1 exclusive SC involvement. Adding AX evaluation to the TA ultrasound increased the diagnostic yield for GCA in 9.6%, whereas adding OC or SCs to the TA and AX ultrasound increased it in 1.4% and 1.8%, respectively. No value was found in adding the FA or CCs. Notably, 13 patients with cranial symptoms and 4 with exclusively cranial symptoms showed negative TA ultrasound but positive AX ultrasound.
CONCLUSIONS: Adding the evaluation of AXs to the TA ultrasound increased the number of patients diagnosed with GCA, even in cases of predominantly cranial symptoms. In the subset of patients where these arteries were assessed, no substantial benefit was found in adding the FA, OC, SC or CC arteries to the TA and AX ultrasonographic assessment.
摘要：
目的：为了评估GCA在将腋窝动脉（AX）添加到颞动脉（TA）超声中的诊断价值，特别是在患有该疾病的颅骨表型的患者中；并研究面部（FA）的效用，枕骨（OC），锁骨下（SC），疑似GCA患者的颈总动脉（CC）超声检查。
方法：新发GCA和TA超声阳性的患者，AX,FA,OC,SC或CC,随后在两个学术中心的风湿病科，被回顾性地包括在内。
结果：对230例患者进行了评估。在206/230例（89.6%）中发现了TA晕征，FA在40/82（48.8%），在17/69（24.6%），AX在56/230（24.3％），SC在31/57（54.4%），和CC在14/68（20.6%）。在24/230（10.4％）患者中发现TA超声阴性：22例具有AX受累，1个独家OC参与和1个独家SC参与。在TA超声中添加AX评估可使GCA的诊断率提高9.6％，而在TA和AX超声中添加OC或SCs则增加了1.4%和1.8%，分别。在添加FA或CC时没有发现任何值。值得注意的是,13例具有颅骨症状的患者和4例仅具有颅骨症状的患者显示TA超声阴性但AX超声阳性。
结论：将AXs的评估添加到TA超声中增加了诊断为GCA的患者数量，即使在主要是颅骨症状的情况下。在评估这些动脉的患者亚组中，没有发现添加FA的实质性好处，OC,SC或CC动脉对TA和AX进行超声检查。
方法：新发GCA和TA超声阳性的患者，AX,FA,OC,SC或CC,随后在两个学术中心的风湿病科，被回顾性地包括在内。
结果：对230例患者进行了评估。在206/230例（89.6%）中发现了TA晕征，FA在40/82（48.8%），在17/69（24.6%），AX在56/230（24.3％），SC在31/57（54.4%），和CC在14/68（20.6%）。在24/230（10.4％）患者中发现TA超声阴性：22例具有AX受累，1个独家OC参与和1个独家SC参与。在TA超声中添加AX评估可使GCA的诊断率提高9.6％，而在TA和AX超声中添加OC或SCs则增加了1.4%和1.8%，分别。在添加FA或CC时没有发现任何值。值得注意的是,13例具有颅骨症状的患者和4例仅具有颅骨症状的患者显示TA超声阴性但AX超声阳性。
结论：将AXs的评估添加到TA超声中增加了诊断为GCA的患者数量，即使在主要是颅骨症状的情况下。在评估这些动脉的患者亚组中，没有发现添加FA的实质性好处，OC,SC或CC动脉对TA和AX进行超声检查。
