Wertigkeit der farbkodierten Duplexsonographie in Abhängigkeit der klinischen Vortest-Wahrscheinlichkeit bei Riesenzellarteriitis

Grau, Cristina; Schnabel, A.

doi:10.1055/s-0029-1241899

Cited by 8 publications

(2 citation statements)

References 16 publications

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“…Of a total of 16 primary studies that examined the diagnostic value of the halo sign demonstrated by temporal artery ultrasonograply versus the ACR 1990 criteria for the classification of vasculitis, used as a reference standard [3,5,6,16-28], only 9 studies met our inclusion/exclusion criteria [3,5,6,17-19,21,24,27]. To avoid duplicate reports on the same patients, one study [3] was excluded.…”

Section: Resultsmentioning

confidence: 99%

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The diagnostic value of ultrasonography-derived edema of the temporal artery wall in giant cell arteritis: a second meta-analysis

Arida¹,

Kyprianou²,

Kanakis³

et al. 2010

BMC Musculoskelet Disord

240

160

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BackgroundUltrasonography of temporal arteries is not commonly used in the approach of patients with suspected giant cell arteritis (GCA) in clinical practice. A meta-analysis of primary studies available through April 2004 concluded that ultrasonography could indeed be helpful in diagnosing GCA. We specifically re-examined the diagnostic value of the ultrasonography-derived halo sign, a dark hypoechoic circumferential thickening around the artery lumen, indicating vasculitic wall edema, in GCA.MethodsOriginal, prospective studies in patients with suspected GCA that examined ultrasonography findings of temporal arteries using the ACR 1990 classification criteria for GCA as reference standard, published through 2009, were identified. Only eight studies involving 575 patients, 204 of whom received the final diagnosis of GCA, fulfilled technical quality criteria for ultrasound. Weighted sensitivity and specificity estimates of the halo sign were assessed, their possible heterogeneity was investigated and pooled diagnostic odds ratio was determined.ResultsUnilateral halo sign achieved an overall sensitivity of 68% (95% CI, 0.61-0.74) and specificity of 91% (95% CI, 0.88-0.94) for GCA. The values of inconsistency coefficient (I2) of both sensitivity and specificity of the halo sign, showed significant heterogeneity concerning the results between studies. Pooled diagnostic odds ratio, expressing how much greater the odds of having GCA are for patients with halo sign than for those without, was 34 (95% CI, 8.21-138.23). Diagnostic odds ratio was further increased to 65 (95% CI, 17.86-236.82) when bilateral halo signs were present (sensitivity/specificity of 43% and 100%, respectively). In both cases, it was found that DOR was constant across studies.ConclusionTemporal artery edema demonstrated as halo sign should be always looked for in ultrasonography when GCA is suspected. Providing that currently accepted technical quality criteria are fulfilled, halo sign's sensitivity and specificity are comparable to those of autoantibodies used as diagnostic tests in rheumatology. Validation of revised GCA classification criteria which will include the halo sign may be warranted.

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Section: Resultsmentioning

confidence: 99%

“…The results of the present meta-analysis further substantiate this algorithm. Moreover, in a recent study involving 182 patients from a single center, albeit not using the ACR criteria as the reference standard, it was found that GCA can be accurately diagnosed or excluded by ultrasonography, without biopsy, in two thirds of patients [28]. …”

Section: Discussionmentioning

confidence: 99%

The diagnostic value of ultrasonography-derived edema of the temporal artery wall in giant cell arteritis: a second meta-analysis

Arida¹,

Kyprianou²,

Kanakis³

et al. 2010

BMC Musculoskelet Disord

240

160

View full text Add to dashboard Cite

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Halo sign on temporal artery ultrasound versus temporal artery biopsy for giant cell arteritis

Pouncey,

Yeldham,

Magan

et al. 2024

Cochrane Database of Systematic Reviews

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Stiegler

2012

Internist

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Vascular ultrasound plays an important role in the visual depiction of arteries, veins, and changes of tissue in lymphatic diseases. In the case of arteries, this ranges from endothelial dysfunction over measuring the increase of intima media thickness to the detection of stenoses, occlusion, or aneurysm. Ultrasound helps to differentiate in functional arterial diseases such as primary and secondary Raynaud's syndrome as well as arterial compression syndromes like entrapment syndrome of different arterial regions or the chronic exceptional compartment syndrome of the lower leg. Ultrasound plays a central role in the diagnosis of rare arterial diseases like large vessel vasculitis, arterial dissection, cystic adventitial degeneration, and the differentiation of vascular malformation especially in children, thus, permitting ultrasound-guided intervention and follow-up controls. In venous thrombosis, sonography is the primary imaging method, while follow-up controls help in the prediction of recurrent venous thrombosis. Ultrasound is a tool to determine the cause and severity of chronic venous insufficiency and allows different therapeutic procedures for the treatment of varicose veins to be visually monitored.

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Wertigkeit der farbkodierten Duplexsonographie in Abhängigkeit der klinischen Vortest-Wahrscheinlichkeit bei Riesenzellarteriitis

Abstract: Taking into account pretest probability, an RCA can be accurately diagnosed or excluded by CDS in two thirds of patients without biopsy. When performed by an experienced investigator CDS is a basic part in the diagnosis of CDA.

Cited by 8 publications

References 16 publications

The diagnostic value of ultrasonography-derived edema of the temporal artery wall in giant cell arteritis: a second meta-analysis

The diagnostic value of ultrasonography-derived edema of the temporal artery wall in giant cell arteritis: a second meta-analysis

Halo sign on temporal artery ultrasound versus temporal artery biopsy for giant cell arteritis

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