Giant Cell Arteritis: Diagnostic Accuracy of MR Imaging of Superficial Cranial Arteries in Initial Diagnosis—Results from a Multicenter Trial

Abstract

MR imaging of superficial cranial arteries is accurate in the initial diagnosis of GCA giant cell arteritis . Sensitivity probably decreases after more than 5 days of sCS systemic corticosteroid therapy; thus, imaging should not be delayed. Clinical trial registration no. DRKS00000594 .

The Role of Ultrasound Compared to Biopsy of Temporal Arteries in the Diagnosis and Treatment of Giant Cell Arteritis (TABUL): a diagnostic accuracy and cost-effectiveness study

“…The sensitivity and specificity of MRI for diagnosing GCA was 78.4% and 90.4%, respectively, and for TAB (in those patients who had biopsy), the sensitivity and specificity were 88.7% and 75%, respectively. 13 The accuracy of the imaging was high if the patients had received either no glucocorticoids or glucocorticoids for no more than 5 days, but more than 5 days of therapy resulted in a significant fall in diagnostic accuracy. A combined approach that used ultrasound to try to identify the most appropriate site for biopsy had no effect on the sensitivity of detecting histological evidence of GCA.…”

“…Imaging first emerged in the 1990s as a potential means by which to provide evidence to support a diagnosis of GCA. [8][9][10][11][12][13][14][15] High-resolution magnetic resonance imaging (MRI) of temporal arteries offers a non-invasive technique for investigating suspected GCA, but it is limited by availability and cost. Ultrasound is the most practical and widely used modality.…”

“…121 Unfortunately, magnetic resonance changes resolve within a few days of starting glucocorticoid therapy and access to magnetic resonance is likely to be a limiting factor, whereas access to ultrasound is much more rapid. 13 The effects of steroids on image appearances for both magnetic resonance and ultrasound have been compared in 59 patients undergoing both tests, as well as in a proportion undergoing TAB. Whereas the sensitivity of ultrasound and magnetic resonance were 92% and 90%, respectively, up to 1 day following steroid therapy, this is reduced to 50% and 80% with > 4 days of steroid therapy.…”

Giant Cell Arteritis with Facial Edema Presenting with Delayed Jugular Venous Flow

“…In this case, phlebostasis was observed on MRI just 1 week after the onset of symptoms, whereas no abnormal arterial findings were indicated. Klink et al (13) reported that MRI of the cranial arteries is accurate and reproducible during the initial diagnosis in patients with suspected GCA, with a sensitivity of 88.7% and a specificity of 75.0% in comparison to the reference standard. In addition to the arterial findings, abnormal jugular venous flow might be detected by MRI at an early stage of GCA in patients presenting with facial edema.…”

Systemic Vasculitis: Novelty in Classification, Diagnosis, and Treatment

“…Например, для выявления гиган- Р е д а к ц и о н н а я с т а т ь я токлеточного артериита, особенно поражений экстра-краниальных артерий, рекомендуется выполнение не только ультразвуковой доплерографии артерий (чувствительность метода -67 %, специфичность -95 %) [5], но и магнитно-резонансной томографии (чувствительность -78,4 %, специфичность -90,4 %) [6], позитронно-эмиссионной томографии [7] и ком-пьютерной томографической ангиографии [8]. Результаты последних исследований позволили описать клинические особенности течения гиган-токлеточного артериита [9].…”