CT Angiography of the Head for the Initial Assessment of Giant Cell Arteritis: Presenting Symptoms, Biopsy Outcomes and Alternative Diagnosis.

BACKGROUND AND PURPOSE: Giant cell arteritis (GCA), a form of large vessel vasculitis, carries the risk of irreversible loss of vision due to involvement of arteries supplying optic nerve, retina and choroid. As such, timely diagnosis of GCA is crucial. The study examines the presenting symptoms among suspected GCA patients with both positive and negative biopsy results and the association of computed tomography angiography (CTA) findings of the suspected GCA patients with superficial temporal artery (STA) biopsy results.

MATERIALS AND

METHODS

A retrospective study involving 22 patients who underwent STA biopsy and CTA at Kingston Health Science Center. The CTA images of the patients were analyzed for the following imaging signs: blurred STA wall, perivascular enhancement, presence of stenosis or occlusion of STA and calcification. The association between imaging signs and STA biopsy results was assessed using odds ratios (ORs). Additionally, the final alternative diagnosis for the patients with negative biopsy results was also investigated.

RESULTS

There was a strong association between the presence of two CTA imaging findings : blurred STA wall and perivascular enhancement, and positive STA biopsy results (OR: 29, p: 0.001). Suspected GCA patients with negative STA biopsy results had no single unifying alternative diagnosis.

CONCLUSION

This study provides evidence for the potential role of CTA in the initial assessment of suspected GCA patients.