BACKGROUND Diagnosis of giant cell arteritis by temporal artery biopsy is time-consuming and visual loss lies in the first week after its diagnosis. The purpose of the study was to test the hypothesis that ultrasound can reduce the risk of overdiagnosis and overtreatment in giant cell arteritis. METHODS Data regarding physical/ clinical features examinations, temporal artery biopsy examinations, ultrasound findings, and magnetic resonance imaging examinations of 980 suspected patients for giant cell arteritis were included in the study. Decision curve analysis was applied to get a beneficial score for selected diagnostic modalities. Cost analysis was performed for each patient. RESULTS Fewer numbers of false positive giant cell arteritis results were reported under physical/ clinical features examinations following ultrasound detection than physical/clinical features examinations following temporal artery biopsy examinations (45 vs. 127, p < 0.0001). The working area that detects giant cell arteritis at least one time for physical/ clinical features examinations following ultrasound detection and physical/ clinical features examinations following temporal artery biopsy examinations were 0-91% and 0-86%. No significant difference for true negative results between magnetic resonance imaging and physical and clinical features examinations following ultrasound detection (p = 0.007). Physical and clinical features examinations following ultrasound detection were less expensive method than physical/ clinical features examinations following temporal artery biopsy examinations (14,023 ± 982 ¥/patient vs. 18,551 ± 1231 ¥/patient, p < 0.0001) and MRI. CONCLUSION Physical and clinical features examinations following ultrasound are recommended for diagnosis of patients with suspected giant cell arteritis.

中文翻译：

---

巨细胞动脉炎患者的超声与颞动脉活检：一项前瞻性队列研究。

背景技术通过颞动脉活检来诊断巨细胞性动脉炎是耗时的，并且视力丧失在于其诊断后的第一周。该研究的目的是检验以下假设，即超声可以减少巨细胞性动脉炎过度诊断和过度治疗的风险。方法这项研究包括了980例疑似巨细胞动脉炎患者的物理/临床特征检查，颞动脉活检，超声检查结果以及磁共振成像检查数据。应用决策曲线分析来获得针对所选诊断方式的有益评分。对每位患者进行了费用分析。结果在超声检测后的物理/临床特征检查中报告的假阳性巨细胞动脉炎结果数量少于颞动脉活检后的物理/临床特征检查（45 vs. 127，p <0.0001）。超声检测后至少进行一次物理/临床特征检查和颞动脉活检后的物理/临床特征检查的一次检测到巨细胞性动脉炎的工作区域为0-91％和0-86％。超声检测后，磁共振成像与物理和临床特征检查之间的真实阴性结果无显着差异（p = 0.007）。超声检测后的物理和临床特征检查比颞动脉活检后的物理/临床特征检查便宜（14,023±982日元/患者vs 18,551±1231日元/患者，p <0.0001）和MRI。结论建议在超声检查后进行物理和临床特征检查，以诊断疑似巨细胞动脉炎的患者。