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Novel ultrasonographic Halo Score for giant cell arteritis: assessment of diagnostic accuracy and association with ocular ischaemia

OBJECTIVES: Ultrasound of temporal and axillary arteries may reveal vessel wall inflammation in patients with giant cell arteritis (GCA). We developed a ultrasound scoring system to quantify the extent of vascular inflammation and investigated its diagnostic accuracy and association with clinical fa...

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Autores principales: van der Geest, Kornelis S M, Borg, Frances, Kayani, Abdul, Paap, Davy, Gondo, Prisca, Schmidt, Wolfgang, Luqmani, Raashid Ahmed, Dasgupta, Bhaskar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034352/
https://www.ncbi.nlm.nih.gov/pubmed/31900304
http://dx.doi.org/10.1136/annrheumdis-2019-216343
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author van der Geest, Kornelis S M
Borg, Frances
Kayani, Abdul
Paap, Davy
Gondo, Prisca
Schmidt, Wolfgang
Luqmani, Raashid Ahmed
Dasgupta, Bhaskar
author_facet van der Geest, Kornelis S M
Borg, Frances
Kayani, Abdul
Paap, Davy
Gondo, Prisca
Schmidt, Wolfgang
Luqmani, Raashid Ahmed
Dasgupta, Bhaskar
author_sort van der Geest, Kornelis S M
collection PubMed
description OBJECTIVES: Ultrasound of temporal and axillary arteries may reveal vessel wall inflammation in patients with giant cell arteritis (GCA). We developed a ultrasound scoring system to quantify the extent of vascular inflammation and investigated its diagnostic accuracy and association with clinical factors in GCA. METHODS: This is a prospective study including 89 patients suspected of having GCA, of whom 58 had a confirmed clinical diagnosis of GCA after 6 months follow-up. All patients underwent bilateral ultrasound examination of the three temporal artery (TA) segments and axillary arteries, prior to TA biopsy. The extent of vascular inflammation was quantified by (1) counting the number of TA segments and axillary arteries with a halo and (2) calculating a composite Halo Score that also incorporated the thickness of each halo. RESULTS: Halo counts and Halo Scores showed moderate diagnostic accuracy for a clinical diagnosis of GCA. They correlated positively with systemic inflammation. When compared with the halo count, the Halo Score correlated better with C-reactive protein (CRP) levels and allowed to firmly establish the diagnosis of GCA in more patients. Higher halo counts and Halo Scores were associated with a higher risk of ocular ischaemia. They allowed to identify subgroups of patients with low risk (≤5%) and high risk of ocular ischaemia (>30%). CONCLUSIONS: Ultrasound halo scoring allows to quantify the extent of vascular inflammation in GCA. Extensive vascular inflammation on ultrasound may provide strong diagnostic confirmation and associates with ocular ischaemia in GCA.
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spelling pubmed-70343522020-03-03 Novel ultrasonographic Halo Score for giant cell arteritis: assessment of diagnostic accuracy and association with ocular ischaemia van der Geest, Kornelis S M Borg, Frances Kayani, Abdul Paap, Davy Gondo, Prisca Schmidt, Wolfgang Luqmani, Raashid Ahmed Dasgupta, Bhaskar Ann Rheum Dis Imaging OBJECTIVES: Ultrasound of temporal and axillary arteries may reveal vessel wall inflammation in patients with giant cell arteritis (GCA). We developed a ultrasound scoring system to quantify the extent of vascular inflammation and investigated its diagnostic accuracy and association with clinical factors in GCA. METHODS: This is a prospective study including 89 patients suspected of having GCA, of whom 58 had a confirmed clinical diagnosis of GCA after 6 months follow-up. All patients underwent bilateral ultrasound examination of the three temporal artery (TA) segments and axillary arteries, prior to TA biopsy. The extent of vascular inflammation was quantified by (1) counting the number of TA segments and axillary arteries with a halo and (2) calculating a composite Halo Score that also incorporated the thickness of each halo. RESULTS: Halo counts and Halo Scores showed moderate diagnostic accuracy for a clinical diagnosis of GCA. They correlated positively with systemic inflammation. When compared with the halo count, the Halo Score correlated better with C-reactive protein (CRP) levels and allowed to firmly establish the diagnosis of GCA in more patients. Higher halo counts and Halo Scores were associated with a higher risk of ocular ischaemia. They allowed to identify subgroups of patients with low risk (≤5%) and high risk of ocular ischaemia (>30%). CONCLUSIONS: Ultrasound halo scoring allows to quantify the extent of vascular inflammation in GCA. Extensive vascular inflammation on ultrasound may provide strong diagnostic confirmation and associates with ocular ischaemia in GCA. BMJ Publishing Group 2020-03 2020-01-03 /pmc/articles/PMC7034352/ /pubmed/31900304 http://dx.doi.org/10.1136/annrheumdis-2019-216343 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Imaging
van der Geest, Kornelis S M
Borg, Frances
Kayani, Abdul
Paap, Davy
Gondo, Prisca
Schmidt, Wolfgang
Luqmani, Raashid Ahmed
Dasgupta, Bhaskar
Novel ultrasonographic Halo Score for giant cell arteritis: assessment of diagnostic accuracy and association with ocular ischaemia
title Novel ultrasonographic Halo Score for giant cell arteritis: assessment of diagnostic accuracy and association with ocular ischaemia
title_full Novel ultrasonographic Halo Score for giant cell arteritis: assessment of diagnostic accuracy and association with ocular ischaemia
title_fullStr Novel ultrasonographic Halo Score for giant cell arteritis: assessment of diagnostic accuracy and association with ocular ischaemia
title_full_unstemmed Novel ultrasonographic Halo Score for giant cell arteritis: assessment of diagnostic accuracy and association with ocular ischaemia
title_short Novel ultrasonographic Halo Score for giant cell arteritis: assessment of diagnostic accuracy and association with ocular ischaemia
title_sort novel ultrasonographic halo score for giant cell arteritis: assessment of diagnostic accuracy and association with ocular ischaemia
topic Imaging
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034352/
https://www.ncbi.nlm.nih.gov/pubmed/31900304
http://dx.doi.org/10.1136/annrheumdis-2019-216343
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