Vasculitis & polymyalgia rheumatica
Diffusion-weighted magnetic resonance imaging for the diagnosis of giant cell arteritis: a comparison with T1-weighted black-blood imaging
Authors' conclusion
DWI of the superficial cranial arteries demonstrates a good diagnostic accuracy and reliability for the diagnosis of GCA.
Study context
- Population
- Patients with clinically suspected GCA; ten arterial segments assessed (common superficial temporal arteries, temporal and parietal branches, occipital and posterior auricular arteries bilaterally)87 with and 69 without GCA
- Participants
- 156 patients
- Comparison
- Diffusion-weighted imaging (DWI) of the superficial cranial arteries vs post-contrast, fat-suppressed T1-weighted black-blood sequence (T1-BB)
- Outcome
- Diagnostic accuracy of DWI for GCA vs expert clinical diagnosis
Methodological detailsretrospective, reference standard: expert clinical diagnosis after ≥6 months of follow-up
- Retrospective
- Reference standard: expert clinical diagnosis after ≥6 months of follow-up
Performance
As reported in the abstract
Diagnostic accuracy for GCA
| Test or model | Sensitivity | Specificity | Positive likelihood ratio |
|---|---|---|---|
| DWI ≥2 slices | 75.9% | 94.2% | 13.09 |
| DWI ≥3 slices | 70.1% | 98.6% | 48.38 |
| T1-BB | 88.5% | 88.4% | 7.63 |
Sensitivity
DWI ≥2 slices75.9%
DWI ≥3 slices70.1%
T1-BB88.5%
Specificity
DWI ≥2 slices94.2%
DWI ≥3 slices98.6%
T1-BB88.4%
Positive likelihood ratio
DWI ≥2 slices13.09
DWI ≥3 slices48.38
T1-BB7.63
- DWI AUC
- 0.90
Further findings
| Outcome | DWI ≥2 SLICES | T1-BB |
|---|---|---|
| Inter-rater agreement (kappa) | ||
| Kappa, patient level | 1.00 | 0.78 |
| Kappa, arterial segment level | 0.85 | 0.79 |
Original publication
Diffusion-weighted magnetic resonance imaging for the diagnosis of giant cell arteritis: a comparison with T1-weighted black-blood imaging. Rheumatology (Oxford). Published 9 August 2023. doi:10.
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