对于疑似巨细胞动脉炎的动脉活检:一个迷你审查
Zhijian Jiang1, Huiying Ji2, Jianhong Dong1
1Department of Ophthalmology, Shanghai Xuhui Central Hospital, Shanghai, China.
Indian journal of ophthalmology
|October 3, 2023
概括
为了改善巨细胞动脉炎 (GCA) 诊断,在皮质类固醇治疗一周内进行关动脉活检 (TAB). 考虑较长的标本和序列段,以减少GCA诊断中的假阴性.
科学领域:
- 类风湿病学 类风湿病学
- 病理学 病理学 病理学
- 血管医学 血管医学
背景情况:
- 巨细胞动脉炎 (GCA) 是一种血管炎,引起中大动脉的炎症.
- 它可以导致严重的缺血并发症.
- 动脉活检 (TAB) 是标准的诊断工具,但有局限性.
研究的目的:
- 审查改善TAB敏感性的证据.
- 为了减少TAB在GCA诊断中的错误阴性率.
- 探索非侵入性成像在GCA诊断中的作用.
主要方法:
- 对TAB和GCA诊断研究的文献综述.
- 分析影响TAB准确性的因素 (定时,样本长度,切片).
- 对非侵入性成像技术 (DUS,CTA,MRA,18F-FDG-PET/CT) 的评估.
主要成果:
- 建议在开始使用皮质类固醇后一周内进行TAB.
- 样本长度为20-30毫米,连续切口可以改善检测.
- 非侵入性成像可以作为辅助诊断方法.
结论:
- 优化TAB程序可以降低GCA中的假负率.
- 及时的TAB和早期的皮质类固醇治疗是至关重要的.
- 非侵入性血管成像有可能补充或部分取代TAB用于GCA诊断.
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