Diagnostic value of high-resolution MR imaging in giant cell arteritis
Diagnostic value of high-resolution MR imaging in giant cell arteritis
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DOI：
10.3174/ajnr.a0638
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发表时间：
2007-10-01
影响因子：
3.5
通讯作者：
Wieben, O.
中科院分区：
文献类型：
--
作者：
Bley, T. A.;Uhl, M.;Wieben, O.
背景与目的：巨细胞动脉炎的临床指征可能不特异，无创诊断往往很困难。本研究探讨了颅浅动脉高分辨率 MR 成像是一种可以检测巨细胞动脉炎发生的无创成像技术的假设。 材料和方法：对 64 名疑似巨细胞动脉炎的连续患者进行对比增强、高分辨率 MR 成像，使用亚毫米平面内空间分辨率的 T1 加权自旋回波图像评估壁厚度、管腔直径和壁对比增强评分。根据美国风湿病学会的临床标准（包括实验室检查和 32 名患者的颞动脉活检结果），风湿科医生的最终诊断被用作评估 MR 成像结果的“金标准”。 结果：所有检查均提供了诊断图像质量。评估诊断血管炎的壁炎 MR 成像征象的敏感性为 80.6%，特异性为 97.0%。相比之下，仅组织学结果就显示出 77.8% 的敏感性和 100% 的特异性。巨细胞动脉炎患者的平均壁厚从 0.39 mm (+/- 0.18 mm) 显着增加至 0.74 mm (+/- 0.32 mm；P < .001)，管腔直径从 0.84 mm (+/- 0.29 mm) 显着减小至 0.65 mm (+/- 0.38 mm；P < .05)。结论：对比度增强、高分辨率磁共振成像可以对巨细胞动脉炎的壁炎症进行无创评估，并具有良好的诊断确定性。可以在这些小血管中获得壁增厚和对比度增强的测量结果，并提供有价值的血管炎 MR 成像结果。
Background and purpose: Clinical indications of giant cell arteritis may be unspecific, and noninvasive diagnosis is often difficult. This study investigated the hypothesis that high-resolution MR imaging of the superficial cranial arteries is a noninvasive imaging technique that can detect the occurrence of giant cell arteritis.Materials and Methods: Contrast-enhanced, high-resolution MR imaging was performed on 64 consecutive patients with suspected giant cell arteritis, Mural thickness, lumen diameter, and a mural contrast enhancement score were assessed with T1-weighted spin-echo images with submillimeter in-plane spatial resolution. The final rheumatologist's diagnosis according to the clinical criteria of the American College of Rheumatology including laboratory tests and results of temporal artery biopsies from 32 patients was used as a "gold standard" for the evaluation of the MR imaging findings.Results: All of the examinations provided diagnostic image quality. Evaluation of the mural inflammatory MR imaging signs for diagnosing vasculitis resulted in a sensitivity of 80.6% and a specificity of 97.0%. In comparison, histology results alone showed a sensitivity of 77.8% and specificity of 100%. The mean wall thickness increased significantly from 0.39 mm (+/- 0.18 mm) to 0.74 mm (+/- 0.32 mm; P < .001), and the lumen diameter decreased significantly from 0.84 mm (+/- 0.29 mm) to 0.65 mm (+/- 0.38 mm; P < .05) for patients with giant cell arteritis.Conclusion: Contrast-enhanced, high-resolution MR imaging allows noninvasive assessment of mural inflammation in giant cell arteritis with good diagnostic certainty. Measures of mural thickening and contrast enhancement can be obtained in these small vessels and provide valuable vasculitic MR imaging findings.