ARTICLE INFO

Article Type

Original Research

Authors

Einollahzade   H. (* )
Samimi   K. (1)
Soltan Sanjari   M. (1 )






(* ) Radiology Department, Medicine Faculty, Iran University of Medical Sciences, Tehran, Iran
(1) Radiology Department, Medicine Faculty, Iran University of Medical Sciences, Tehran, Iran

Correspondence

Address: 4th Floor, No.2, Sanei Dead End, Fifth Street, Dr. Fatemi Avenue, tehran, Iran
Phone: +982188996660
Fax: +982188957948
herad2010@yahoo.com

Article History

Received:  April  14, 2014
Accepted:  June 10, 2014
ePublished:  July 1, 2014

BRIEF TEXT


During 1950s and 1960s, lumbar muscle pain was regarded as the most common symptoms of temporal arteritis [1, 2]. According to a study, PMR might be regarded as simple and undeveloped form of TA [3]. … [4-9] Based on two naming methods, the giant cell arteritis is a more proper name than temporal arteritis [10, 11]. For many years, TAB was treated as the golden standard in GCA diagnosis, performed immediately on subjects suspected to GCA and A- AION. In this case, there was about 23% to 35% false negative response probability [12]. … [13] Duplex ultrasonography provides useful information about vascular walls, as well as the lumens. Using the method, several arteries, probably influenced by GCA, can be investigated [14]. The dark halo is the most specific symptoms for GCA in duplex ultrasonography method [15].

In Iran, there is no conducted study comparing biopsy method with duplex ultrasonography method in diagnosis of temporal arteritis.

The aim of this study was to investigate sensitivity, specificity, accuracy, positive predicative value, and negative predicative value of duplex ultrasonography method compared to biopsy invasive method.

This is a cross-sectional study.

Patients from Rasool-e-Akram Hospital ophthalmologic ward suspected to have temporal arteritis (based on clinical symptoms) were studied from March 2012 to March 2013.

20 patients, including 14 women and 6 men, were selected, using convenient sampling method.

Ultrasonography was done on three sections of the superficial temporal arteritis (CSTA), and parietal (STA-P) and frontal (STA-F) branches in both longitudinal and transverse sections [15]. Before biopsy, the subjects underwent colored duplex ultrasonography immediately after black and white ultrasonography. Based on the predetermined framework, each of the following items was treated as a TA sign: Stenosis (narrowing of the vessel lumen); occlusion (highlighting the temporal artery without any color or Doppler signal waves); halo sign (hypoechoic region and thick wall surrounding the temporal artery) Based on the biopsy results, the patients were divided into ‘with temporal arteritis’ and ‘without temporal arteritis’ groups. Main criterion in temporal arteritis diagnosis was the results from temporal artery biopsy test. The results from ultrasonography compared with those of the temporal artery biopsy, using statistical comparison. Kappa and McNemar tests, as well as accuracy, sensitivity, specificity, positive predicative value, and negative predicative value equations for accuracy determination, were used.

Mean age of the patients was 62.05±14.58years. Regarding the least and the highest ages, i. e. 46 and 79 years respectively, the patients were divided into four age groups, as follows: 50 years old and lesser (2 persons); 51 to 60 years old (7 persons), 61 to 70 years (7 persons), and more than 70 years (4 persons) At 5% P Value, there was no significant statistical correlation between two variables. 14 (70%) and 6 (30%) study patients were female and male, respectively. With Chi Square statistical test showing significant difference, the epidemic was 57.1% and 33.3% in women and men, respectively. This shows significantly higher rate of the diseases among women than men do. In duplex ultrasonography, halo sign, temporal arteritis stenosis, and artery wall irregularity were treated as temporal arteritis signs (Table 1). The resulted probabilities from the tests showed significant correlation between the two variables at 95% confidence levels. Of duplex ultrasonography, sensitivity (ratio of patients truly diagnosed by duplex ultrasonography to total patients), specificity (ratio of healthy persons truly diagnosed by duplex ultrasonography to total healthy persons), positive predicative value (ratio of patients to persons diagnosed as patient by duplex ultrasonography), negative predicative value (ratio of healthy persons to persons diagnosed as healthy by duplex ultrasonography), and accuracy (ratio of persons truly diagnosed by duplex ultrasonography to total persons), were 100%, 76.9%, 70%, 100%, and 85%, respectively. To describe agreement between two methods, Kappa coefficient was computed 0.7. Kappa test probability showed significant difference between Kappa coefficients of two methods at 5% P Value. Regarding probability equal to 0.250 at 0.05 P Value for McNemar test, and based on the sample, there is no evidence on inconsistency between biopsy and duplex ultrasonography methods.

Regarding high sensitivity and specificity, the results are consistent with those of another conducted study [15]. … [16-21] Regarding sensitivity, the results are consistent with a conducted meta-analysis, while there is no consistency in sensitivity [22]. Regarding sensitivity, specificity, positive predicative value, negative predicative value, and general value of ultrasonography method, the results of the present study are consistent with those of another study [23].

Symptoms of temporal arteritis with ultrasonography method ought to be prepared for the physicians, in order to increase sensibility and specificity of the method in temporal arteritis diagnosis.

Few sample number was one of the limitations for the present study.

In temporal arteritis diagnosis, duplex ultrasonography method seems to be a proper alternative for biopsy invasive method; and as far as no other vascular disease diagnosed by tests, there is no need for biopsy in temporal arteritis diagnosis.

The researchers feel grateful to all the patients participated in the study and those who collaborated in the research.

Non-declared

Since the used method was a stage in the disease diagnosis, there was no need to any confirmation except proposal confirmation.

Iran University of Medical Sciences founded the research.

TABLES and CHARTS

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