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Definitions and reliability assessment of elementary ultrasound lesions in giant cell arteritis: a study from the OMERACT Large Vessel Vasculitis Ultrasound Working Group.
- Chrysidis, Stavros;
- Duftner, Christina;
- Dejaco, Christian;
- Schäfer, Valentin;
- Ramiro, Sofia;
- Carrara, Greta;
- Scirè, Carlo;
- Hocevar, Alojzija;
- Diamantopoulos, Andreas;
- Iagnocco, Annamaria;
- Mukhtyar, Chetan;
- Ponte, Cristina;
- Naredo, Esperanza;
- De Miguel, Eugenio;
- Bruyn, George;
- Warrington, Kenneth;
- Terslev, Lene;
- Milchert, Marcin;
- DAgostino, Maria;
- Koster, Mattew;
- Rastalsky, Naina;
- Hanova, Petra;
- Macchioni, Pierluigi;
- Kermani, Tanaz;
- Lorenzen, Tove;
- Døhn, Uffe;
- Fredberg, Ulrich;
- Hartung, Wolfgang;
- Dasgupta, Bhaskar;
- Schmidt, Wolfgang
Abstract
Objectives
To define the elementary ultrasound (US) lesions in giant cell arteritis (GCA) and to evaluate the reliability of the assessment of US lesions according to these definitions in a web-based reliability exercise.Methods
Potential definitions of normal and abnormal US findings of temporal and extracranial large arteries were retrieved by a systematic literature review. As a subsequent step, a structured Delphi exercise was conducted involving an expert panel of the Outcome Measures in Rheumatology (OMERACT) US Large Vessel Vasculitis Group to agree definitions of normal US appearance and key elementary US lesions of vasculitis of temporal and extracranial large arteries. The reliability of these definitions on normal and abnormal blood vessels was tested on 150 still images and videos in a web-based reliability exercise.Results
Twenty-four experts participated in both Delphi rounds. From originally 25 statements, nine definitions were obtained for normal appearance, vasculitis and arteriosclerosis of cranial and extracranial vessels. The halo and compression signs were the key US lesions in GCA. The reliability of the definitions for normal temporal and axillary arteries, the halo sign and the compression sign was excellent with inter-rater agreements of 91-99% and mean kappa values of 0.83-0.98 for both inter-rater and intra-rater reliabilities of all 25 experts.Conclusions
The halo and the compression signs are regarded as the most important US abnormalities for GCA. The inter-rater and intra-rater agreement of the new OMERACT definitions for US lesions in GCA was excellent.Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.
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