The “Dot Sign” a New Diagnostic Finding in Giant-Cell Arteritis

Castiglione, Juan Ignacio; Hawkes, Maximiliano A.; Ameriso, Sebastián F.

doi:10.4103/0028-3886.359260

Cited by 3 publications

(1 citation statement)

References 1 publication

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“…In 2019, Matsuoka et al reported, to our knowledge, the first case with an abnormal DWI signal of the temporal arteries (TAs) [10]. Recently, a few additional cases of DWI in GCA were published [11][12][13]. DWI is based on the measurement of random Brownian motion of water molecules.…”

Section: Introductionmentioning

confidence: 99%

Diffusion-weighted magnetic resonance imaging for the diagnosis of giant cell arteritis – a comparison with T1-weighted black-blood imaging

Seitz

Bucher

Bütikofer

et al. 2023

Preprint

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Objectives: To investigate the diagnostic performance of diffusion-weighted imaging (DWI) of the superficial cranial arteries in the diagnosis of giant cell arteritis (GCA). Methods: Retrospectively, 156 patients with clinically suspected GCA were included. A new 4-point ordinal DWI rating scale was developed. A post-contrast, fat-suppressed, T1-weighted "black-blood" sequence (T1-BB) was rated for comparison. Ten arterial segments were assessed: common superficial temporal arteries, temporal and parietal branches, occipital and posterior auricular arteries bilaterally. The expert clinical diagnosis after ≥ 6 months of follow-up was the diagnostic reference standard. Diagnostic accuracy was evaluated for different rating methods. Results: The study cohort consisted of 87 patients with and 69 without GCA. For DWI, the area under the curve was 0.90. For a cut-off of ≥ 2 consecutive pathological slices, DWI showed a sensitivity of 75.9%, a specificity of 94.2% and a positive likelihood ratio of 13.09. With a cut-off of ≥ 3 consecutive pathological slices, sensitivity was 70.1%, specificity was 98.6%, and the positive likelihood ratio was 48.38. For the T1-BB, values were 88.5%, 88.4% and 7.63, respectively. The inter-rater analysis for DWI with a cut-off of ≥ 2 pathological slices showed a kappa of 1.00 on the patient level and 0.85 on the arterial segment level. For the T1-BB the kappa was 0.78 and 0.79, respectively. Conclusion: DWI of the superficial cranial arteries demonstrates a good diagnostic accuracy and reliability for the diagnosis of GCA. DWI is widely available and can be used immediately in clinical practice for patients with suspected GCA.

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Section: Introductionmentioning

confidence: 99%

Diffusion-weighted magnetic resonance imaging for the diagnosis of giant cell arteritis – a comparison with T1-weighted black-blood imaging

Seitz

Bucher

Bütikofer

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

Diffusion-weighted magnetic resonance imaging for the diagnosis of giant cell arteritis: a comparison with T1-weighted black-blood imaging

et al. 2023

View full text Add to dashboard Cite

Objectives To investigate the diagnostic performance of diffusion-weighted imaging (DWI) of the superficial cranial arteries in the diagnosis of giant cell arteritis (GCA). Methods Retrospectively, 156 patients with clinically suspected GCA were included. A new 4-point ordinal DWI rating scale was developed. A post-contrast, fat-suppressed, T1-weighted “black-blood” sequence (T1-BB) was rated for comparison. Ten arterial segments were assessed: common superficial temporal arteries, temporal and parietal branches, occipital and posterior auricular arteries bilaterally. The expert clinical diagnosis after ≥ 6 months of follow-up was the diagnostic reference standard. Diagnostic accuracy was evaluated for different rating methods. Results The study cohort consisted of 87 patients with and 69 without GCA. For DWI, the area under the curve was 0.90. For a cut-off of ≥ 2 consecutive pathological slices, DWI showed a sensitivity of 75.9%, a specificity of 94.2% and a positive likelihood ratio of 13.09. With a cut-off of ≥ 3 consecutive pathological slices, sensitivity was 70.1%, specificity was 98.6%, and the positive likelihood ratio was 48.38. For the T1-BB, values were 88.5%, 88.4% and 7.63, respectively. The inter-rater analysis for DWI with a cut-off of ≥ 2 pathological slices showed a kappa of 1.00 on the patient level and 0.85 on the arterial segment level. For the T1-BB the kappa was 0.78 and 0.79, respectively. Conclusion DWI of the superficial cranial arteries demonstrates a good diagnostic accuracy and reliability for the diagnosis of GCA. DWI is widely available and can be used immediately in clinical practice for patients with suspected GCA.

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DWI scrolling artery sign for the diagnosis of giant cell arteritis: a pattern recognition approach

Seitz,

Bucher,

Bütikofer

et al. 2024

RMD Open

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ObjectivesTo investigate the diagnostic accuracy of a pattern recognition approach for the evaluation of MRI scans of the head with diffusion-weighted imaging (DWI) in suspected giant cell arteritis (GCA).MethodsRetrospectively, 156 patients with suspected GCA were included. The ‘DWI-Scrolling-Artery-Sign’ (DSAS) was defined as hyperintense DWI signals in the cranial subcutaneous tissue that gives the impression of a blood vessel when scrolling through a stack of images. The DSAS was rated by experts and a novice in four regions (frontotemporal and occipital, bilaterally). The temporal, occipital and posterior auricular arteries were assessed in the T1-weighted black-blood sequence (T1-BB). The diagnostic reference was the clinical diagnosis after ≥6 months of follow-up.ResultsThe population consisted of 87 patients with and 69 without GCA; median age was 71 years and 59% were women. The DSAS showed a sensitivity of 73.6% and specificity of 94.2% (experts) and 59.8% and 95.7% (novice), respectively. Agreement between DSAS and T1-BB was 80% for the region level (499/624; kappa(κ)=0.59) and 86.5% for the patient level (135/156; κ=0.73). Inter-reader agreement was 95% (19/20; κ=0.90) for DSAS on the patient level and 91.3% (73/80; κ=0.81) on the region level for experts. For expert versus novice, inter-reader agreement for DSAS was 87.8% on the patient level (137/156; κ=0.75) and 91.2% on the region level (569/624; κ=0.77).ConclusionsThe DSAS can be assessed in less than 1 min and has a good diagnostic accuracy and reliability for the diagnosis of GCA. The DSAS can be used immediately in clinical practice.

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The “Dot Sign” a New Diagnostic Finding in Giant-Cell Arteritis

Cited by 3 publications

References 1 publication

Diffusion-weighted magnetic resonance imaging for the diagnosis of giant cell arteritis – a comparison with T1-weighted black-blood imaging

Diffusion-weighted magnetic resonance imaging for the diagnosis of giant cell arteritis – a comparison with T1-weighted black-blood imaging

Diffusion-weighted magnetic resonance imaging for the diagnosis of giant cell arteritis: a comparison with T1-weighted black-blood imaging

DWI scrolling artery sign for the diagnosis of giant cell arteritis: a pattern recognition approach

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