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COLOUR DOPPLER SONOGRAPHY OF FACIAL AND OCCIPITAL ARTERIES IN PATIENTS WITH GIANT CELL ARTERITIS

Rok Ješe ; Department of Rheumatology, University Medical Centre Ljubljana, Slovenia
Žiga Rotar ; Department of Rheumatology, University Medical Centre Ljubljana, Slovenia
Matija Tomšič ; Department of Rheumatology, University Medical Centre Ljubljana, Slovenia
Alojzija Hočevar ; Department of Rheumatology, University Medical Centre Ljubljana, Slovenia

Sažetak

Background: Giant cell arteritis (GCA) is the most common systemic large and medium size artery vasculitis in Western countries. Colour Doppler Sonography (CDS) allows the study of involvement of cranial arteries other than the temporal arteries, which are inconvenient to biopsy, such as the facial (FaA), and occipital (OcA) arteries.
Objectives: We aimed to estimate the frequency of the FaA, and OcA involvement in GCA; and to explore the clinical characteristics of these subgroups of patients.
Methods: From 1 January 2014 to 31 December 2016, we prospectively performed a CDS of the FaA, and OcA in addition to the temporal (TA), and the extracranial supra-aortic arteries in all newly diagnosed patients suspected of having GCA. We used a Philips IU22 with a 5–17.5 MHz multi-frequency linear probe from January 2014 to August 2016 and a Philips Epiq 7 with a 5–18 MHz multi-frequency linear probe from September 2016 to December 2016. All the arteries were evaluated in two planes for the highly specific halo-sign.
Results: During the 36-month observation period we performed a CDS of the cranial and extra-cranial arteries in 93 GCA (66.7% female) patients. The patients’ median (IQR) age was 73.7 (66.1–79.1) years, and they had a median (IQR) symptom duration of 30 (21–90) days. We observed the halo-sign on the FaA, and OcA in 38 (40.9%), and 29 (31.2%) cases, respectively. The FaA, and OcA were simultaneously affected in 18/93 (19.4%) cases. Either FaA, or OcA were affected in 4/22 (18.2%) patients with a negative TA CDS. FaA involvement significantly correlated with jaw claudication and with severe visual manifestations, including permanent visual loss. Patients with OcA involvement least commonly had extracranial large vessel disease. Conclusions: A fifth of patients with a negative CDS of the TAs had signs of vasculitis on the CDS of the FaA, or OcA. Th e addition of FaA and OcA CDS to the routine CDS of the TAs could identify 4.3% more patients and thus further improve the sensitivity of the CDS in the suspected GCA.
References:
1. Ješe R, Rotar Ž, Tomšič M, Hočevar A. Th e role of colour doppler ultrasonography of facial and occipital arteries in patients with giant
cell arteritis: A prospective study. European Journal of Radiology. 2017;95:9–12.

Ključne riječi

Hrčak ID:

210535

URI

https://hrcak.srce.hr/210535

Datum izdavanja:

5.12.2018.

Posjeta: 647 *