Value of contrast-enhanced ultrasound in evaluating clinical stage of patients with temporal artery giant cell arteritis

doi:10.3877/cma.j.issn.1672-6448.2025.04.013

Abstract

Abstract:

Objective

To explore the value of contrast-enhanced ultrasound （CEUS） in evaluating the clinical stage of patients with giant cell arteritis （GCA） of superficial temporal arteries.

Methods

From January 2020 to March 2024， 87 patients clinically diagnosed with GCA at Ningbo No.2 Hospital were enrolled.According to the criteria established by the National Institutes of Health （NIH）， patients were categorized into active and inactive groups.All patients underwent blood inflammatory index testing， routine temporal artery ultrasound， and CEUS examinations.The differences in blood inflammatory indices， routine temporal artery ultrasound parameters， and CEUS parameters between patients in the active and inactive groups were comparatively analyzed， as well as the various parameters among patients with different CEUS grades.The changes in various parameters before and after treatment in patients in the active phase were analyzed， along with the correlations between the intima-media thickness （IMT） of the vessel wall， CEUS grade， C-reactive protein （CRP）， erythrocyte sedimentation rate （ESR）， and monocytes in patients in the active phase.

Results

Among the 87 patients， 72 were in the active phase of GCA and 15 were in the inactive phase.The differences in CRP， ESR， IMT， and CEUS grade between the two groups were statistically significant （t=8.976， 9.029， and 3.324， and χ²=12.135， respectively， all P＜0.05）.The differences in CRP， ESR，monocytes， and IMT among different CEUS grades were statistically significant （F=32.978， 81.550， 6.432，and 21.664， respectively， all P＜0.05）.Using CEUS grade ≥ 2 as the criterion for evaluating the active phase of GCA， the diagnostic sensitivity and specificity were 75% and 100%， respectively.In patients with active GCA， CEUS grade was moderately positively correlated with CRP （r=0.72， P＜0.001） and significantly positively correlated with ESR （r=0.846， P＜0.001）.In patients with active temporal artery GCA， the higher the CEUS grade before treatment， the more significant the decrease in CRP and ESR after treatment（F=36.653 and 98.279， respectively， P＜0.001）， while IMT had no significant difference （H=20.465， P＞0.05）.

Conclusion

CEUS can accurately assess the clinical stages and the degree of inflammation of GCA，providing imaging evidence to guide timely adjustment of clinical treatment plans and improve the prognosis of patients with temporal artery GCA.

Key words: Giant cell arteries, Clinical staging, Contrast-enhanced ultrasound, Superficial temporal arteries

Xiang Gu, Xiyuan Tian, Zhifei Ben. Value of contrast-enhanced ultrasound in evaluating clinical stage of patients with temporal artery giant cell arteritis[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2025, 22(04): 368-373.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2025.04.013

https://chaosheng.cma-cmc.com.cn/EN/Y2025/V22/I04/368

Figures/Tables 4

资料	活动期组（n=72）	非活动期组（n=15）	统计值	P值
性别［例（%）］			χ ²=-0.722	0.472
男	41（56.94）	7（46.67）
女	31（63.06）	8（53.33）
年龄（岁， $\overset{ˉ}{x}$ ± s ）	73.39±8.99	64.8±8.79	t= 0.377	0.651
身高（cm， $\overset{ˉ}{x}$ ± s ）	163.38±0.08	162.27±0.09	t= 0.485	0.629
体重（kg， $\overset{ˉ}{x}$ ± s ）	60.14±11.09	59.83±7.45	t= 0.102	0.919
BMI（kg/m²， $\overset{ˉ}{x}$ ± s ）	22.4±2.97	22.78±2.76	t= -0.456	0.65
CRP［mg/L，M ( Q₁,　 Q₃ )］	84.43（12.1，152.4）	4.8（2.14，6.23）	Z= 8.976	＜ 0.001
ESR［mm/h，M ( Q₁,　 Q₃ )］	49.13（19.2，92.1）	13.53（5.23，21.12）	Z= 9.029	＜ 0.001
单核细胞［10⁹/L，M ( Q₁,　 Q₃ )］	0.67（0.23，0.98）	0.46（0.23，0.58）	Z= 0.596	0.543
血小板［10⁹/L，M ( Q₁,　 Q₃ )］	272.71（171.21，321.85）	254.47（144.23，381.23）	Z= 0.597	0.552
IMT（mm， $\overset{ˉ}{x}$ ± s ）	0.49±0.20	0.31±0.15	t= 3.324	0.001
管径（mm， $\overset{ˉ}{x}$ ± s ）	1.79±0.34	1.65±0.29	t= 1.532	0.129
CEUS 分级［例（%）］			χ ²=12.135	＜ 0.001
0 级	8（11.11）	14（93.33）
1 级	10（13.89）	1（6.67）
2 级	22（30.56）	0
3 级	32（44.44）	0

资料	活动期组（n=72）	非活动期组（n=15）	统计值	P值
性别［例（%）］			χ ²=-0.722	0.472
男	41（56.94）	7（46.67）
女	31（63.06）	8（53.33）
年龄（岁， $\overset{ˉ}{x}$ ± s ）	73.39±8.99	64.8±8.79	t= 0.377	0.651
身高（cm， $\overset{ˉ}{x}$ ± s ）	163.38±0.08	162.27±0.09	t= 0.485	0.629
体重（kg， $\overset{ˉ}{x}$ ± s ）	60.14±11.09	59.83±7.45	t= 0.102	0.919
BMI（kg/m²， $\overset{ˉ}{x}$ ± s ）	22.4±2.97	22.78±2.76	t= -0.456	0.65
CRP［mg/L，M ( Q₁,　 Q₃ )］	84.43（12.1，152.4）	4.8（2.14，6.23）	Z= 8.976	＜ 0.001
ESR［mm/h，M ( Q₁,　 Q₃ )］	49.13（19.2，92.1）	13.53（5.23，21.12）	Z= 9.029	＜ 0.001
单核细胞［10⁹/L，M ( Q₁,　 Q₃ )］	0.67（0.23，0.98）	0.46（0.23，0.58）	Z= 0.596	0.543
血小板［10⁹/L，M ( Q₁,　 Q₃ )］	272.71（171.21，321.85）	254.47（144.23，381.23）	Z= 0.597	0.552
IMT（mm， $\overset{ˉ}{x}$ ± s ）	0.49±0.20	0.31±0.15	t= 3.324	0.001
管径（mm， $\overset{ˉ}{x}$ ± s ）	1.79±0.34	1.65±0.29	t= 1.532	0.129
CEUS 分级［例（%）］			χ ²=12.135	＜ 0.001
0 级	8（11.11）	14（93.33）
1 级	10（13.89）	1（6.67）
2 级	22（30.56）	0
3 级	32（44.44）	0

资料	0 级（n=22）	1 级（n=11）	2 级（n=22）	3 级（n=32）	统计值	P值
性别［例（%）］					χ ²=0.165	0.919
男	11（50.0）	6（54.5）	11（50.0）	18（56.3）
女	11（50.0）	5（45.5）	11（50.0）	14（43.7）
年龄（岁）	69.08±10.27	73.75±8.11	72.23±11.46	73.16±8.47	F= 1.170	0.326
身高（cm）	162.46±9.47	164.13±7.38	164.00±6.31	162.97±7.95	F= 0.191	0.902
体重（kg）	60.20±9.80	60.19±9.15	65.81±11.74	57.62±10.74	F= 1.933	0.131
BMI（kg/m²）	22.76±2.85	22.26±2.28	24.43±3.76	21.54±2.57^c	F= 3.404	0.021
CRP（mg/L）	11.55±9.08	21.68±9.93	98.03±59.65^ab	132.18±74.47^ab	F= 32.978	＜ 0.001
ESR（mm/h）	13.27±6.54	20.50±8.77	57.92±21.40^ab	72.31±20.58^abc	F= 81.550	＜ 0.001
单核细胞（10⁹/L）	0.48±0.15	0.54±0.25	0.76±0.33^a	0.76±0.33^a	F= 6.432	＜ 0.001
血小板（10⁹/L）	240.77±114.85	266.63±87.91	327.92±75.34	270.72±114.86	F= 1.979	0.123
IMT（mm）	0.30±0.14	0.38±0.13	0.56±0.13^ab	0.60±0.18^ab	F= 21.664	＜ 0.001
管径（mm）	1.71±0.30	1.73±0.25	1.91±0.40	1.77±0.36	F= 1.142	0.337

参数	0 级（n=8）	1 级（n=10）	2 级（n=22）	3 级（n=32）	统计值	P值
CRP（mg/L， $\overset{ˉ}{x}$ ± s ）	5.06±3.42	11.82±7.26	56.18±34.8	84.12±47.88	F=36.653	＜ 0.001
ESR（mm/h， $\overset{ˉ}{x}$ ± s ）	3.75±4.16	10.88±6.6	35.23±15.1	46.16±13.44	F=98.279	＜ 0.001
IMT ［mm，M ( Q₁,　 Q₃ )］	0.00（0.00，0.00）	0.00（0.00，0.00）	0.10（0.00，0.10）	0.10（0.00，0.10）	H=20.465	0.106

参数	0 级（n=8）	1 级（n=10）	2 级（n=22）	3 级（n=32）	统计值	P值
CRP（mg/L， $\overset{ˉ}{x}$ ± s ）	5.06±3.42	11.82±7.26	56.18±34.8	84.12±47.88	F=36.653	＜ 0.001
ESR（mm/h， $\overset{ˉ}{x}$ ± s ）	3.75±4.16	10.88±6.6	35.23±15.1	46.16±13.44	F=98.279	＜ 0.001
IMT ［mm，M ( Q₁,　 Q₃ )］	0.00（0.00，0.00）	0.00（0.00，0.00）	0.10（0.00，0.10）	0.10（0.00，0.10）	H=20.465	0.106

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