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Ultrasound halo count in the differential diagnosis of atherosclerosis and large vessel giant cell arteritis

OBJECTIVE: To determine the diagnostic discriminant validity between large vessel giant cell arteritis (LV-GCA) and atherosclerosis using ultrasound (US) intima-media thickness (IMT) measurements. METHODS: We included 44 patients with LV-GCA and 42 with high-risk atherosclerosis. US examinations of...

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Autores principales: Monjo-Henry, Irene, Fernández-Fernández, Elisa, Mostaza, José María, Lahoz, Carlos, Molina-Collada, Juan, de Miguel, Eugenio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9926809/
https://www.ncbi.nlm.nih.gov/pubmed/36788547
http://dx.doi.org/10.1186/s13075-023-03002-0
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author Monjo-Henry, Irene
Fernández-Fernández, Elisa
Mostaza, José María
Lahoz, Carlos
Molina-Collada, Juan
de Miguel, Eugenio
author_facet Monjo-Henry, Irene
Fernández-Fernández, Elisa
Mostaza, José María
Lahoz, Carlos
Molina-Collada, Juan
de Miguel, Eugenio
author_sort Monjo-Henry, Irene
collection PubMed
description OBJECTIVE: To determine the diagnostic discriminant validity between large vessel giant cell arteritis (LV-GCA) and atherosclerosis using ultrasound (US) intima-media thickness (IMT) measurements. METHODS: We included 44 patients with LV-GCA and 42 with high-risk atherosclerosis. US examinations of the axillary, subclavian, and common carotid arteries (CCA) were systematically performed using a MylabX8 system (Genoa, Italy) with a 4–15-MHz probe. IMT ≥ 1 mm was accepted as pathological. RESULTS: The LV-GCA cohort included 24 females and 20 males with a mean age of 72.8 ± 7.6 years. The atherosclerosis group included 25 males and 17 females with a mean age of 70.8 ± 6.5 years. The mean IMT values of all arteries included were significantly higher in LV-GCA than in atherosclerosis. Among LV-GCA patients, IMT ≥ 1 mm was seen in 31 axillary, 30 subclavian, and 28 CCA. In the atherosclerotic cohort, 17 (38.6%) had IMT ≥ 1 mm with axillary involvement in 2 patients, subclavian in 3 patients, carotid distal in 14 patients (5 bilateral), and isolated carotid proximal affectation in 1 case. A cutoff point greater than 1 pathological vessel in the summative count of axillary and subclavian arteries or at least 3 vessels in the count of six vessels, including CCA, showed a precision upper 95% for GCA diagnosis. CONCLUSION: The IMT is higher in LV-GCA than in atherosclerosis. The proposed US halo count achieves an accuracy of > 95% for the differential diagnosis between LV-GCA and atherosclerosis. The axillary and subclavian arteries have higher discriminatory power, while carotid involvement is less specific in the differential diagnosis.
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spelling pubmed-99268092023-02-15 Ultrasound halo count in the differential diagnosis of atherosclerosis and large vessel giant cell arteritis Monjo-Henry, Irene Fernández-Fernández, Elisa Mostaza, José María Lahoz, Carlos Molina-Collada, Juan de Miguel, Eugenio Arthritis Res Ther Research OBJECTIVE: To determine the diagnostic discriminant validity between large vessel giant cell arteritis (LV-GCA) and atherosclerosis using ultrasound (US) intima-media thickness (IMT) measurements. METHODS: We included 44 patients with LV-GCA and 42 with high-risk atherosclerosis. US examinations of the axillary, subclavian, and common carotid arteries (CCA) were systematically performed using a MylabX8 system (Genoa, Italy) with a 4–15-MHz probe. IMT ≥ 1 mm was accepted as pathological. RESULTS: The LV-GCA cohort included 24 females and 20 males with a mean age of 72.8 ± 7.6 years. The atherosclerosis group included 25 males and 17 females with a mean age of 70.8 ± 6.5 years. The mean IMT values of all arteries included were significantly higher in LV-GCA than in atherosclerosis. Among LV-GCA patients, IMT ≥ 1 mm was seen in 31 axillary, 30 subclavian, and 28 CCA. In the atherosclerotic cohort, 17 (38.6%) had IMT ≥ 1 mm with axillary involvement in 2 patients, subclavian in 3 patients, carotid distal in 14 patients (5 bilateral), and isolated carotid proximal affectation in 1 case. A cutoff point greater than 1 pathological vessel in the summative count of axillary and subclavian arteries or at least 3 vessels in the count of six vessels, including CCA, showed a precision upper 95% for GCA diagnosis. CONCLUSION: The IMT is higher in LV-GCA than in atherosclerosis. The proposed US halo count achieves an accuracy of > 95% for the differential diagnosis between LV-GCA and atherosclerosis. The axillary and subclavian arteries have higher discriminatory power, while carotid involvement is less specific in the differential diagnosis. BioMed Central 2023-02-14 2023 /pmc/articles/PMC9926809/ /pubmed/36788547 http://dx.doi.org/10.1186/s13075-023-03002-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Monjo-Henry, Irene
Fernández-Fernández, Elisa
Mostaza, José María
Lahoz, Carlos
Molina-Collada, Juan
de Miguel, Eugenio
Ultrasound halo count in the differential diagnosis of atherosclerosis and large vessel giant cell arteritis
title Ultrasound halo count in the differential diagnosis of atherosclerosis and large vessel giant cell arteritis
title_full Ultrasound halo count in the differential diagnosis of atherosclerosis and large vessel giant cell arteritis
title_fullStr Ultrasound halo count in the differential diagnosis of atherosclerosis and large vessel giant cell arteritis
title_full_unstemmed Ultrasound halo count in the differential diagnosis of atherosclerosis and large vessel giant cell arteritis
title_short Ultrasound halo count in the differential diagnosis of atherosclerosis and large vessel giant cell arteritis
title_sort ultrasound halo count in the differential diagnosis of atherosclerosis and large vessel giant cell arteritis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9926809/
https://www.ncbi.nlm.nih.gov/pubmed/36788547
http://dx.doi.org/10.1186/s13075-023-03002-0
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