Objectives The objective of this study was to evaluate the sensitivity and scores of vascular US before and after initiating glucocorticoid (GC) treatment in patients with new-onset giant cell arteritis (GCA). Methods Treatment-naïve patients with GCA were prospectively included. 18F-fluorodeoxyglucose (18F-FDG) PET/CT, US and temporal artery (TA) biopsy were performed in all patients. US was repeated 3 and 10 days after GC commencement. Intima-media thickness and presence of halo signs were assessed. Sonographers were unblinded to the clinical data. The OMERACT GCA Ultrasonography score (OGUS) and the halo count (HC) were calculated. Results Forty-eight patients were included. Before GC exposure, US sensitivity was 94% (95% CI: 83–99), 73% (95% CI: 58–85), and 71% (95% CI: 56–83) when assessing all vessels, TAs, and large vessels (LVs), respectively. At day 3 and 10, the overall US sensitivity was 92% (95% CI: 78–98, P = 0.16) and 83% (95% CI: 69–92, P = 0.10), respectively. At day 10, the TA-US and LV-US sensitivity was 53% (95% CI: 38–68, P < 0.01) and 60% (95% CI: 44–74, P = 0.13), respectively. The median OGUS decreased from 1.06 (IQR 0.83–1.24) to 0.95 (IQR 0.78–1.14, P < 0.01) and 0.90 (IQR 0.73–1.01, P < 0.001) after 3 and 10 days, respectively. The median HC decreased from 3 (IQR 2–5) to 2 (IQR 1–4, P < 0.01) after 10 days. Conclusion The vasculitic US findings expressed by OGUS diminished after 3 days of GC treatment. TA-US sensitivity decreased after 10 days, whereas LV-US was less likely to change, highlighting the importance of LV-assessment. Consistent with the EULAR recommendations, these findings encourage prompt US assessment, preferably within 3 days, to ensure an accurate diagnosis.

中文翻译：

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巨细胞动脉炎患者治疗前、治疗后 3 天和 10 天超声敏感性和评分的系列评估


目的 本研究的目的是评估新发巨细胞动脉炎 （GCA） 患者开始糖皮质激素 （GC） 治疗前后血管 US 的敏感性和评分。方法 前瞻性纳入初治 GCA 患者。对所有患者进行 18F-氟脱氧葡萄糖 （18F-FDG） PET/CT、US 和颞动脉 （TA） 活检。在 GC 开始后 3 天和 10 天重复 US。评估了内膜中层厚度和光晕体征的存在。超声医师对临床数据不知情。计算 OMERACT GCA 超声评分 （OGUS） 和光晕计数 （HC）。结果 共纳入 48 例患者。在 GC 暴露之前，在评估所有血管、TA 和大型血管 （LV） 时，US 敏感性分别为 94% （95% CI： 83-99） 、73% （95% CI： 58-85） 和 71% （95% CI： 56-83）。在第 3 天和第 10 天，美国总体敏感性分别为 92% （95% CI： 78-98，P = 0.16） 和 83% （95% CI： 69-92，P = 0.10）。第 10 天，TA-US 和 LV-US 敏感性分别为 53% （95% CI： 38-68， P < 0.01） 和 60% （95% CI： 44-74， P = 0.13）。3 天和 10 天后，中位 OGUS 分别从 1.06 （IQR 0.83-1.24） 下降到 0.95 （IQR 0.78-1.14，P < 0.01）和 0.90 （IQR 0.73-1.01，P < 0.001）。10 天后，中位 HC 从 3 （IQR 2-5） 下降到 2 （IQR 1-4，P < 0.01）。结论 GC 治疗 3 天后，OGUS 表达的血管炎 US 结果减少。TA-US 敏感性在 10 天后降低，而 LV-US 不太可能发生变化，突出了 LV 评估的重要性。与 EULAR 建议一致，这些发现鼓励及时进行 US 评估，最好在 3 天内进行评估，以确保准确诊断。