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RETROSPECTIVE STUDY OF RADIOLOGICAL PREDICTORS OF GIANT CELL ARTERITIS IN BIOPSY PROVEN CASES OF GIANT CELL ARTERITIS IN BUFFALO, NEW YORK
Abstract
Background and Aims
Giant cell arteritis (GCA) is a clinical and a pathological diagnosis supported by laboratory imaging findings. Biopsy of the STA is positive only in 50% of GCA cases. We aim to identify radiological predictors of GCA.
Methods
A single-center, retrospective chart and image review of suspected cases of GCA. Abnormal findings of the STA on CT Angiogram (CTA) were assessed in both biopsy positive and negative cases. Radiographic findings of blurred vessel wall margins with enhancement, stenosis or occlusion, and calcification of the STA were assessed bilaterally and correlated with the biopsy results.
Results
A total of 615 cases were reviewed. Seventeen biopsy-proven cases were compared with twenty-six biopsy-negative suspected GCA cases. Fisher’s Exact Test showed significant findings (p<.001 and p = .001, respectively) for ipsilateral and contralateral STA changes on CTA head in biopsy-proven cases. Ipsilateral STA changes in imaging have a negative predictive value of 90.9%, a positive predictive value of 88.2 %, specificity of 76.9%, and sensitivity of 71.4%. Regarding the specific radiographic findings, significant findings were found with stenosis or occlusion on ipsilateral STA (p < .001), blurred vessel wall with enhancement in contralateral STA (p<.001), stenosis or occlusion in contralateral STA (p=.03) but nonsignificant for ipsilateral findings of blurred vessel wall margins with enhancement (p=0.168), or calcification (p= .151), and contralateral calcification of STA (p=.395).
Conclusions
CTA head can be an effective tool to predict biopsy positivity in suspected cases of GCA along with clinical and laboratory parameters and it improves the diagnostic yield of STA biopsy.