Doppler ultrasound and giant cell arteritis

Abstract

Ana Marina Suelves1, Enrique España-Gregori1,2, Jose Tembl3, Stephanie Rohrweck1, Jose Maria Millán4, Manuel Díaz-Llopis1,4,51Service of Ophthalmology, La Fe University Hospital, Valencia, Spain; 2Department of Optics, University of Valencia, Valencia, Spain; 3Service of Neurology, La Fe University Hospital, Valencia, Spain; 4CIBERER, Ciber de Enfermedades Raras, Valencia, Spain; 5Faculty of Medicine, University of Valencia, Valencia, SpainObjective: To evaluate the utility of ultrasound in aiding the diagnosis of giant cell arteritis (GCA), in monitoring the response to corticotherapy, and in detecting early relapses.Methods: A pilot study, prospective, included 10 patients with suspected GCA. All patients underwent ultrasound examination of both temporal arteries before temporal artery biopsy (TAB), 3 weeks after starting treatment, and 3 months after diagnosis. For this study, the histological findings alone were used to define if patients were suffering from GCA. The findings on ultrasound were compared with the results of biopsy. The best place to perform TAB was observed by ultrasound.Results: All patients with positive biopsy were detected with ultrasound. No false positives were observed on ultrasound. The results presented give a sensibility, specificity, and positive predictive value of 100% for the use of ultrasound in the diagnosis of GCA. Two relapses were detected early by ultrasound during the follow-up.Conclusions: This pilot study suggests that eco-doppler may be a useful tool in diagnosis and clinic follow-up in patients with suspected GCA.Keywords: giant cell arteritis, ultrasound, temporal artery biopsy, optic nerve