PDF(Pubmed)
Abstract：
UNASSIGNED: The objective of this study was 2-fold: first, to evaluate whether superb microvascular imaging (SMI) could be used to visualize neovascularization in temporal arteries, and, second, to evaluate the diagnostic performance of high frequency ultrasound with SMI using an extended protocol in patients with suspected giant cell arteritis (GCA).
UNASSIGNED: This retrospective study comprised 120 patients consecutively examined with an extended CDU protocol (temporal, facial, axillary, subclavian, brachiocephalic, and carotid arteries) between 2020 and 2022. Of all patients, 107 had no previous GCA diagnosis and 13 had a previous GCA diagnosis. SMI was used to evaluate neovascularization in the temporal arteries. Arteritis were characterized as low- or medium-echogenic, homogeneous wall thickening, with or without a positive compression sign in the temporal arteries. The Halo count, i.e., the number of temporal and axillary artery segments with signs of arteritis, was evaluated. The reference was clinically diagnosed GCA confirmed after ≥6-month follow-up.
UNASSIGNED: Of the eligible 107 patients with new suspected GCA, 33 (31%) received a clinical GCA diagnosis. Neovascularization was detected in 14 patients (43%). Patients with neovascularization displayed a higher halo count [median 6 (25th-75th percentile 4.75-7) vs. 3 (2-4-4), p = 0.005]. CDU of only the temporal arteries showed sensitivity and specificity (95% confidence intervals) of 94% (80-100%) and 100% (95-100%), respectively. The addition of extra-cranial arteries increased the sensitivity to 100%. Of the 13 patients investigated for suspected relapse, three had a clinically confirmed relapse. One of them displayed neovascularization together with other signs of inflammation.
UNASSIGNED: We show for the first time that inflammatory neovascularization of the temporal arteries can be detected by SMI. Neovascularization is associated with a more-widespread cranial disease. The value of neovascularization should be further investigated, especially for the detection of GCA relapse.
UNASSIGNED: This retrospective study comprised 120 patients consecutively examined with an extended CDU protocol (temporal, facial, axillary, subclavian, brachiocephalic, and carotid arteries) between 2020 and 2022. Of all patients, 107 had no previous GCA diagnosis and 13 had a previous GCA diagnosis. SMI was used to evaluate neovascularization in the temporal arteries. Arteritis were characterized as low- or medium-echogenic, homogeneous wall thickening, with or without a positive compression sign in the temporal arteries. The Halo count, i.e., the number of temporal and axillary artery segments with signs of arteritis, was evaluated. The reference was clinically diagnosed GCA confirmed after ≥6-month follow-up.
UNASSIGNED: Of the eligible 107 patients with new suspected GCA, 33 (31%) received a clinical GCA diagnosis. Neovascularization was detected in 14 patients (43%). Patients with neovascularization displayed a higher halo count [median 6 (25th-75th percentile 4.75-7) vs. 3 (2-4-4), p = 0.005]. CDU of only the temporal arteries showed sensitivity and specificity (95% confidence intervals) of 94% (80-100%) and 100% (95-100%), respectively. The addition of extra-cranial arteries increased the sensitivity to 100%. Of the 13 patients investigated for suspected relapse, three had a clinically confirmed relapse. One of them displayed neovascularization together with other signs of inflammation.
UNASSIGNED: We show for the first time that inflammatory neovascularization of the temporal arteries can be detected by SMI. Neovascularization is associated with a more-widespread cranial disease. The value of neovascularization should be further investigated, especially for the detection of GCA relapse.
摘要：
■这项研究的目的是2倍：首先，为了评估高超的微血管成像（SMI）是否可以用来可视化颞动脉的新生血管，and,第二,使用扩展方案评估SMI高频超声在疑似巨细胞动脉炎（GCA）患者中的诊断性能。
■这项回顾性研究包括120名连续接受扩展CDU方案（时间，面部,腋窝,锁骨下,头臂,和颈动脉）在2020年至2022年之间。在所有患者中，107人以前没有GCA诊断，13人以前有GCA诊断。SMI用于评估颞动脉中的新生血管形成。动脉炎的特征是低或中回声，均匀的壁厚，颞动脉有或没有阳性压迫征。光环计数，即，有动脉炎征象的颞动脉段和腋下动脉段的数量，进行了评估。参考为≥6个月随访后临床确诊的GCA。
■在符合条件的107例新的疑似GCA患者中，33例(31%)接收了临床GCA诊断。在14例患者中检测到新生血管形成(43%)。新血管形成的患者显示出较高的晕轮计数[中位数6（第25-75百分位数4.75-7）与3(2-4-4),p=0.005]。仅颞动脉的CDU显示94%（80-100%）和100%（95-100%）的敏感性和特异性（95%置信区间），分别。添加颅外动脉可将敏感性提高到100％。在接受调查的13名疑似复发患者中，有3例临床确诊复发.其中之一显示新血管形成以及其他炎症迹象。
■我们首次表明，可以通过SMI检测到颞动脉的炎性新血管形成。新生血管形成与更广泛的颅骨疾病相关。新生血管的价值应该进一步研究，特别是对GCA复发的检测。
■这项回顾性研究包括120名连续接受扩展CDU方案（时间，面部,腋窝,锁骨下,头臂,和颈动脉）在2020年至2022年之间。在所有患者中，107人以前没有GCA诊断，13人以前有GCA诊断。SMI用于评估颞动脉中的新生血管形成。动脉炎的特征是低或中回声，均匀的壁厚，颞动脉有或没有阳性压迫征。光环计数，即，有动脉炎征象的颞动脉段和腋下动脉段的数量，进行了评估。参考为≥6个月随访后临床确诊的GCA。
■在符合条件的107例新的疑似GCA患者中，33例(31%)接收了临床GCA诊断。在14例患者中检测到新生血管形成(43%)。新血管形成的患者显示出较高的晕轮计数[中位数6（第25-75百分位数4.75-7）与3(2-4-4),p=0.005]。仅颞动脉的CDU显示94%（80-100%）和100%（95-100%）的敏感性和特异性（95%置信区间），分别。添加颅外动脉可将敏感性提高到100％。在接受调查的13名疑似复发患者中，有3例临床确诊复发.其中之一显示新血管形成以及其他炎症迹象。
■我们首次表明，可以通过SMI检测到颞动脉的炎性新血管形成。新生血管形成与更广泛的颅骨疾病相关。新生血管的价值应该进一步研究，特别是对GCA复发的检测。
