彩色多普勒超声在诊断巨细胞颞动脉炎中的应用价值

目的：探讨彩色多普勒超声在诊断巨细胞颞动脉炎（GCTA）中的临床应用价值及其超声分型。方法：分析经病理证实的15例GCTA的超声表现和特点,并根据声像图特征进行超声分型。结果：GCTA的超声形态学特征性改变为：二维超声图像上主要表现为血管壁呈向心性增厚,血管腔内径变窄;彩色多普勒血流显像示颞动脉血管腔周围有一特征性的低回声“晕”;另一种表现为血管壁呈不规则增厚,回声增强,血管腔狭窄,血管腔内血流信号呈周边充盈缺损样改变。超声诊断阳性病例为15例,临床病理活检证实12例,3例为超声诊断假阳性,超声诊断准确率为80％,敏感性为100％。根据超声图像改变,将GCTA分为两型：肉芽肿型和类动脉硬化型。结论：高分辨力超声诊断GCTA简单、适用、无创伤性,有助于提高GCTA的诊断准确率。

The clinical application value of color Doppler sonography in diagnosis and classification of giant cell temporal arteritis

Objective To observe the value of color Doppler sonography in the diagnosis and classification of giant cell temporal arteritis(GCTA).Methods The sonographic characteristics in 15 cases of GCTA confirmed pathologically were analyzed,according to the manifestation of GCTA the classification was made.Results The 2-dimensional sonographic characteristics were the concentric thickness of the temporal artery wall,the main sonographic criterion for positive diagnosis was visualization of a "holo" around the temporal artery by CDFI;the other characteristic manifestation was irregular thickness and hyperechogenicity of the temporal artery wall with irregular lunen stenosis.Among 15 cases there were 12 positive and 3 false-positive in temporal artery biopsy.The sonographic diagnostic accurency was 80%(12/15)and the diagnostic sensitivity was 100%.According to the sonographic manifestations,the GCTA was classified as granulomatous type and vascular atherosclerotic type.Conclusions Color Doppler sonography has high diagnostic accuracy and it can be regarded as a new examination method for diagoning GCTA.