[Doppler color echocardiography in the diagnosis of giant cell arteritis]

Although temporal artery biopsy is still the gold standard for the diagnosis of giant cell arteritis (GCA), there is growing evidence that characteristic findings in color Doppler ultrasonography (CD US) of superficial temporal arteries may be of diagnostic relevance. The current question is if CD US can replace biopsy in the diagnosis of temporal artery arteritis. Several studies have been conducted comparing the validity of the American College of Rheumatology criteria (ACR), biopsy and CD US, in the diagnosis of this vasculitis. It has been demonstrated that temporal artery biopsy is the most specific; however it was showed that the sensibility for the biopsy and ACR criteria is not sufficient and that the ACR criteria have a very low positive predictive value, which may have negative implications on the therapeutic approach of the patients. On the other hand, US CD has a better sensibility when compared to the biopsy and the ACR criteria, with a good specificity, positive and negative predictive values. US CD is a cheap, quick and non-invasive test, with a good viability and reliability, as several studies have demonstrated, namely a study held by the authors of this paper. In conclusion, US CD is an effective method in the diagnosis of GCA, especially with a high suspicion index, working also as an auxiliary method in biopsy-guidance, disease activity and recurrence monitoring.