Over a few decades, temporal artery biopsy (TAB) was regarded as the gold standard for diagnosis of giant-cell arteritis (GCA). However, is it really necessary to use this invasive test in all patients with GCA, particularly in those with typical clinical features of the disease? Can we replace TAB with imaging modalities, including ultrasound and [18F]-fluorodeoxyglucose positron emission tomography (PET), that are more sensitive and/or more readily available in many institutions? Dejaco et al said yes in the recently published European League Against Rheumatism recommendations for the use of imaging in large-vessel vasculitis in clinical practice.1 The authors suggested that in patients in whom there is a high clinical suspicion of GCA and a positive ultrasound, the diagnosis of GCA may be made without biopsy or further imaging. Other imaging modalities, that is, PET and/or MRI, are more valuable in patients with Takayasu-like GCA without cranial signs and symptoms. Noteworthy, the task force clearly emphasised that TAB should be performed in all cases, where GCA cannot be confirmed or excluded based on clinical, laboratory and imaging results. Moreover, TAB should still be a …

中文翻译：

---

颞动脉活检在巨细胞动脉炎患者中的作用存在争议

几十年来，颞动脉活检（TAB）被认为是诊断巨细胞动脉炎（GCA）的金标准。然而，是否真的有必要在所有 GCA 患者中使用这种侵入性检测，尤其是那些具有该疾病典型临床特征的患者？我们能否用成像方式代替 TAB，包括超声和 [18F]-氟脱氧葡萄糖正电子发射断层扫描 (PET)，它们在许多机构中更敏感和/或更容易获得？Dejaco 等人在最近发表的欧洲抗风湿病联盟关于在临床实践中对大血管血管炎使用影像学的建议中表示同意。 1 作者建议，对于临床高度怀疑 GCA 且超声阳性的患者， GCA 的诊断可能无需活检或进一步成像。其他影像学检查方法，即 PET 和/或 MRI，对于没有颅骨体征和症状的 Takayasu 样 GCA 患者更有价值。值得注意的是，专责小组明确强调，对于无法根据临床、实验室和影像学结果确认或排除 GCA 的所有情况，都应进行 TAB。此外，TAB 应该仍然是一个……