Ultrasound halo count in the diferential 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 th...
| Autores: | , , , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2023 |
| País: | España |
| Institución: | Universidad Autónoma de Madrid |
| Repositorio: | Biblos-e Archivo. Repositorio Institucional de la UAM |
| Idioma: | inglés |
| OAI Identifier: | oai:repositorio.uam.es:10486/708687 |
| Acceso en línea: | http://hdl.handle.net/10486/708687 https://dx.doi.org/10.1186/s13075-023-03002-0 |
| Access Level: | acceso abierto |
| Palabra clave: | Giant cell arteritis Large vessel vasculitis Atherosclerosis Diagnosis Imaging Ultrasonography Medicina |
| Sumario: | 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 atherosclero‑ sis 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 signifcantly 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 involve‑ ment in 2 patients, subclavian in 3 patients, carotid distal in 14 patients (5 bilateral), and isolated carotid proximal afectation in 1 case. A cutof point greater than 1 pathological vessel in the summative count of axillary and sub‑ clavian 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 diferential diagnosis between LV-GCA and atherosclerosis. The axillary and subclavian arteries have higher discriminatory power, while carotid involvement is less specifc in the diferential diagnosis |
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