Vasculitis & polymyalgia rheumatica
Diagnostic accuracy of ultrasound versus cranial MRI for giant cell arteritis: dependence on cardiovascular risk for ultrasound only
Authors' conclusion
For the total population T1fs-BB-MRI outperformed ultrasound due to its higher specificity. For patients without high to very high CVR, both modalities perform comparably. In patients with high to very high CVR, MRI has better diagnostic accuracy.
Study context
- Population
- Patients ≥50 years evaluated for suspected giant cell arteritis (GCA) with both MRI and US; reference: expert diagnosis ≥6 months74 with GCA, 70 without
- Participants
- 44 patients
- Comparison
- Cranial contrast-enhanced 3 T 2D T1-fatsat black-blood (T1fs-BB) MRI vs US of the temporal arteries
- Outcome
- Diagnostic accuracy for GCA (sensitivity, specificity) vs expert diagnosis
- Follow-up
- ≥6 months
Methodological detailsretrospective, single-centre
- Retrospective
- Single-centre
Performance
As reported in the abstract
Diagnostic accuracy for GCA vs expert diagnosis ≥6 months
| Test or model | Sensitivity | Specificity |
|---|---|---|
| MRI | 87.8% (78.5-93.5%)Sensitivity on a scale from 0 to 100 percent | 87.1% (77.3-93.1%)Specificity on a scale from 0 to 100 percent |
| Ultrasound intima media thickness (IMT) cut-offs | 86.5% (76.9-92.5%)Sensitivity on a scale from 0 to 100 percent | 74.3% (63.0-83.1%)Specificity on a scale from 0 to 100 percent |
| OMERACT signs | 87.8% (78.5-93.5%)Sensitivity on a scale from 0 to 100 percent | 72.9% (61.5-81.9%)Specificity on a scale from 0 to 100 percent |
Sensitivity
MRI87.8% (78.5-93.5%)
Ultrasound intima media thickness (IMT) cut-offs86.5% (76.9-92.5%)
OMERACT signs87.8% (78.5-93.5%)
Sensitivity on a scale from 0 to 100 percentSpecificity
MRI87.1% (77.3-93.1%)
Ultrasound intima media thickness (IMT) cut-offs74.3% (63.0-83.1%)
OMERACT signs72.9% (61.5-81.9%)
Specificity on a scale from 0 to 100 percentFurther findings
Binary agreement between MRI and ultrasound
- Patient level
- 79.2% to 83.3%
- Segment level
- 84.7% to 85.0%
Diagnostic accuracy in high to very high cardiovascular risk (CVR) subgroup (54 (37.5%) patients)
- MRI preserves its diagnostic accuracy, specificity drops considerably for ultrasound
Original publication
Diagnostic accuracy of ultrasound versus cranial MRI for giant cell arteritis: dependence on cardiovascular risk for ultrasound only. Rheumatology (Oxford). Published 16 April 2026. doi:10.
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