Comparison between colour duplex sonography findings and different histological patterns of temporal artery

Francesco Muratore, Luigi Boiardi, Giovanna Restuccia, Pierluigi Macchioni, Giulia Pazzola, Alberto Nicolini, Giuseppe Germanò, Niccolò Possemato, Alberto Cavazza, Silvio Cavuto, Luca Cimino, Nicolò Pipitone, Mariagrazia Catanoso, Olga Addimanda, Carlo Salvarani

Research output: Contribution to journalArticlepeer-review


Objective. To assess the findings of temporal artery colour duplex sonography (CDS) in GCA characterized by a histological pattern of periadventitial small vessel vasculitis (SVV) and/or vasa vasorum vasculitis (VVV) and compare it with those observed in classic GCA with transmural vasculitis.Methods. We studied 30 patients with SVV and/or VVV, 63 patients with classic GCA and 67 biopsy-negative patients identified over a 9-year period. CDS of the temporal arteries was performed in all patients by one ultrasonographer. Temporal artery biopsy was used as the reference standard. Sensitivities, specificities and likelihood ratios (LRs) were calculated.Results. The frequency of the halo sign on CDS was significantly lower in the patients with SVV and/or VVV compared with those with classic GCA (20% vs 82.5%, P = 0.0001). The halo sign had a sensitivity of only 20% (95% CI 8.4, 39.1%) and a specificity of 80.6% (95% CI 68.7, 88.9%) for the diagnosis of SVV and/or VVV. The negative LR was 0.992 (CI 0.824, 1.195), and the positive LR was 1.030 (CI 0.433, 2.451). The halo sign for the diagnosis of biopsy-proven classic GCA had a higher sensitivity of 82.5% (CI 70.5, 90.5%), the same specificity of 80.6% (CI 68.7, 88.9%) and a higher positive LR (4.253; CI 2.577, 7.021).Conclusion. The halo sign is infrequently found in GCA characterized by a histological pattern of SVV and/or VVV. This limits the sensitivity of CDS in correctly identifying patients with GCA.

Original languageEnglish
Article numberket258
Pages (from-to)2268-2274
Number of pages7
Issue number12
Publication statusPublished - Dec 2013


  • Giant cell arteritis
  • Halo
  • Periadventitial small-vessel vasculitis
  • Transmural vasculitis
  • Ultrasonography

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)


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