[Color duplex ultrasound of the temporal artery: replacement for biopsy in temporal arteritis]

The diagnosis of temporal arteritis (TA) is generally confirmed by biopsy. To investigate the diagnostic accuracy of color duplex sonography (CDS), both temporal arteries of 20 patients with suspected TA were prospectively insonated prior to biopsy. Detection of >or=1 hypoechogenic perivascular halo was used as CDS criterion, a temporal artery biopsy and the criteria of the American College of Rheumatology (ACR) as references. The frequency of halo disappearance after 3 months of steroid therapy was also studied. CDS showed TA in 6, biopsy in 12 and ACR criteria in 15 patients. CDS sensitivity was 50 and 40%, and specificity 100%, using the biopsy and the ACR criteria, respectively. After 3 months of steroid treatment, 1 patient still showed halos. In conclusion, detection of halos confirms, whereas the absence of halos does not exclude the diagnosis of TA suggesting that ultrasound may replace biopsy in single patients with typical clinical signs and symptoms and a halo.