Diagnostic performance of temporal artery ultrasound for the diagnosis of giant cell arteritis: a systematic review and meta-analysis of the literature

Rinagel, Marina; Chatelus, Emmanuel; Jousse‐Joulin, Sandrine; Sibilia, Jean; Gottenberg, Jacques-Éric; Chasset, François; Arnaud, Laurent

doi:10.1016/j.autrev.2018.07.012

Cited by 82 publications

(51 citation statements)

References 33 publications

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“…On meta-analysis the sensitivity and specificity of a unilateral hypoechoic halo compared to positive TAB were respectively of 68% (95% Confidence Intervals (CI): 57-78) and 81%. The diagnostic value of any abnormality on CDUS, such as hypoechoic halo and/or stenosis and/or occlusion, compared to TAB had a sensitivity of 78% (95% CI, 64-87), a specificity of 79% [43].…”

Section: Recommendationmentioning

confidence: 96%

European Headache Federation recommendations for neurologists managing giant cell arteritis

et al. 2020

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Background and aim: Giant cell arteritis (GCA) remains a medical emergency because of the risk of sudden irreversible sight loss and rarely stroke along with other complications. Because headache is one of the cardinal symptoms of cranial GCA, neurologists need to be up to date with the advances in investigation and management of this condition. The aim of this document by the European Headache Federation (EHF) is to provide an evidence-based and expert-based recommendations on GCA. Methods: The working group identified relevant questions, performed systematic literature review and assessed the quality of available evidence, and wrote recommendations. Where there was not a high level of evidence, the multidisciplinary (neurology, ophthalmology and rheumatology) group recommended best practice based on their clinical experience. Results: Across Europe, fast track pathways and the utility of advanced imaging techniques are helping to reduce diagnostic delay and uncertainty, with improved clinical outcomes for patients. GCA is treated with high dose glucocorticoids (GC) as a first line agent however long-term GC toxicity is one of the key concerns for clinicians and patients. The first phase 2 and phase 3 randomised controlled trials of Tocilizumab, an IL-6 receptor antagonist, have been published. It is now been approved as the first ever licensed drug to be used in GCA. Conclusion: The present article will outline recent advances made in the diagnosis and management of GCA.

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Section: Recommendationmentioning

confidence: 96%

European Headache Federation recommendations for neurologists managing giant cell arteritis

et al. 2020

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“…It can detect vessel wall edema, termed as the “halo sign,” throughout the length of the vessel 108 ) . Although the diagnostic properties of temporal artery ultrasound may be more useful compared to temporal artery biopsy, for the diagnosis of giant cell arteries, physicians should be keep in mind to the potential pitfalls (transducer pressure, gray-scale settings, color Doppler settings, and so on) 109 , 110 ) .…”

Section: Other Aspects Of Assessments Using Carotid Ultrasonographmentioning

confidence: 99%

Usefulness of Carotid Ultrasonography for Risk Stratification of Cerebral and Cardiovascular Disease

Nezu

Hosomi

2020

JAT

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Carotid ultrasonography is useful for the assessments of the risk stratification for stroke or coronary artery disease, because it is a simple, repeatable, and noninvasive procedure. The carotid intima-media thickness (IMT), which is assessed using carotid ultrasonography, is a widely used surrogate marker for the severity of atherosclerosis. Several large clinical studies showed that increased carotid IMT is associated with the future stroke or cardiovascular events. In addition, in many clinical trials, it has been adopted for surrogate markers of clinical endpoints of medical intervention. Moreover, carotid ultrasonography allows the measurement of the presence and characteristics of plaques and the severity of carotid artery stenosis. The unstable morphology of plaque, such as hypoechoic, ulcer, and mobility, is associated with future ischemic stroke events. The screening tool of asymptomatic carotid artery stenosis is also important, although whether routine carotid ultrasonography assessment is recommended in the general population remains controversial. The screening of carotid artery stenosis using ultrasonography is essential for not only daily clinical settings but also management of patients with acute ischemic stroke. The patients with atherothrombotic stroke with severe internal carotid artery stenosis should be considered to surgical intervention, and duplex ultrasound approach is important to estimate for the severity of carotid stenosis. Physicians should keep in mind the usefulness of carotid ultrasonography for risk stratification of cerebral and cardiovascular disease based on various aspects. In addition, visual assessment or dynamic changes using carotid ultrasonography could provide the various and valuable insights in clinical settings.

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“…The latter is also useful in multiterritorial or occult disease 4. In a recent meta-analysis, hypoechoic halo on TA ultrasound is shown to have better sensitivity than biopsy,5 and when used concomitantly, it can add significantly to the diagnostic yield 6. This case highlights the dilemma of arriving at GCA diagnosis in practice, often by combining all the above tests.…”

Section: Descriptionmentioning

confidence: 90%

Connecting the dots: a story of unknown fever, acute coronary syndrome and pan-aortitis—an occult relapse of a large vessel vasculitis

et al. 2019

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Diagnostic performance of temporal artery ultrasound for the diagnosis of giant cell arteritis: a systematic review and meta-analysis of the literature

Cited by 82 publications

References 33 publications

European Headache Federation recommendations for neurologists managing giant cell arteritis

European Headache Federation recommendations for neurologists managing giant cell arteritis

Usefulness of Carotid Ultrasonography for Risk Stratification of Cerebral and Cardiovascular Disease

Connecting the dots: a story of unknown fever, acute coronary syndrome and pan-aortitis—an occult relapse of a large vessel vasculitis

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