OBJECTIVES To compare the diagnostic accuracy of 3D versus 2D contrast-enhanced vessel-wall (CE-VW) MRI of extracranial and intracranial arteries in the diagnosis of GCA. METHODS This prospective two-center study was approved by a national research ethics board and enrolled participants from December 2014 to October 2017. A protocol including both a 2D and a 3D CE-VW MRI at 3 T was performed in all patients. Two neuroradiologists, blinded to clinical data, individually analyzed separately and in random order 2D and 3D sequences in the axial plane only or with reformatting. The primary judgment criterion was the presence of GCA-related inflammatory changes of extracranial arteries. Secondary judgment criteria included inflammatory changes of intracranial arteries and the presence of artifacts. A McNemar's test was used to compare 2D to 3D CE-VW MRIs. RESULTS Seventy-nine participants were included in the study (42 men and 37 women, mean age 75 (± 9.5 years)). Fifty-one had a final diagnosis of GCA. Reformatted 3D CE-VW was significantly more sensitive than axial-only 3D CE-VW or 2D CE-VW when showing inflammatory change of extracranial arteries: 41/51(80%) versus 37/51 (73%) (p = 0.046) and 35/50 (70%) (p = 0.03). Reformatted 3D CE-VW was significantly more specific than 2D CE-VW: 27/27 (100%) versus 22/26 (85%) (p = 0.04). 3D CE-VW showed higher sensitivity than 2D CE-VW when detecting inflammatory changes of intracranial arteries: 10/51(20%) versus 4/50(8%), p = 0.01. Interobserver agreement was excellent for both 2D and 3D CE-VW MRI: κ = 0.84 and 0.82 respectively. CONCLUSIONS 3D CE-VW MRI supported more accurate diagnoses of GCA than 2D CE-VW. KEY POINTS • 3D contrast-enhanced vessel-wall magnetic resonance imaging is a high accuracy, non-invasive diagnostic tool used to diagnose giant cell arteritis. • 3D contrast-enhanced vessel-wall imaging is feasible for clinicians to complete within a relatively short time, allowing immediate assessment of extra and intracranial arteries. • 3D contrast-enhanced vessel-wall magnetic resonance imaging might be considered a diagnostic tool when intracranial manifestation of GCA is suspected.

中文翻译：

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使用 3 T 三维脂肪饱和对比增强血管壁磁共振成像提高巨细胞动脉炎的诊断准确性。

目的 比较颅外和颅内动脉的 3D 与 2D 对比增强血管壁 (CE-VW) MRI 在 GCA 诊断中的诊断准确性。方法 这项前瞻性双中心研究获得了国家研究伦理委员会的批准，并在 2014 年 12 月至 2017 年 10 月期间招募了参与者。对所有患者进行了包括 2D 和 3D CE-VW MRI 的 3 T 方案。两名对临床数据不知情的神经放射学家单独单独分析并以随机顺序仅在轴向平面或重新格式化的 2D 和 3D 序列进行分析。主要判断标准是颅外动脉是否存在 GCA 相关炎症改变。次要判断标准包括颅内动脉的炎症变化和伪影的存在。麦克尼马尔 s 检验用于比较 2D 和 3D CE-VW MRI。结果 79 名参与者被纳入研究（42 名男性和 37 名女性，平均年龄 75 岁（± 9.5 岁））。51 人最终诊断为 GCA。当显示颅外动脉的炎症变化时，重新格式化的 3D CE-VW 比仅轴向 3D CE-VW 或 2D CE-VW 更敏感：41/51 (80%) 与 37/51 (73%) (p = 0.046)和 35/50 (70%) (p = 0.03)。重新格式化的 3D CE-VW 比 2D CE-VW 更具体：27/27 (100%) 与 22/26 (85%) (p = 0.04)。在检测颅内动脉炎症变化时，3D CE-VW 显示出比 2D CE-VW 更高的灵敏度：10/51(20%) 与 4/50(8%)，p = 0.01。2D 和 3D CE-VW MRI 的观察者间一致性非常好：分别为 κ = 0.84 和 0.82。结论 3D CE-VW MRI 支持比 2D CE-VW 更准确的 GCA 诊断。要点 • 3D对比增强血管壁磁共振成像是一种用于诊断巨细胞动脉炎的高精度、非侵入性诊断工具。• 3D 对比增强血管壁成像对于临床医生来说是可行的，可以在相对较短的时间内完成，从而可以立即评估颅外和颅内动脉。• 当怀疑GCA 的颅内表现时，3D 对比增强血管壁磁共振成像可能被视为一种诊断工具。允许立即评估颅外和颅内动脉。• 当怀疑GCA 的颅内表现时，3D 对比增强血管壁磁共振成像可能被视为一种诊断工具。允许立即评估颅外和颅内动脉。• 当怀疑GCA 的颅内表现时，3D 对比增强血管壁磁共振成像可能被视为一种诊断工具。