Clinical Application of Contrast-Enhanced Ultrasound in Giant Cell Arteritis.

Objective: The application of contrast-enhanced ultrasound (CEUS) to evaluate temporal arterial wall enhancement in giant cell arteritis (GCA) provides valuable information for evaluating disease activity and predicting treatment response.

Methods: A total of 90 patients clinically diagnosed with GCA at our hospital between January 2020 and March 2024 were enrolled. Patients were divided into an active group and an inactive group based on the NIH criteria. All patients underwent conventional temporal artery ultrasound and CEUS. Differences in blood inflammatory indicators, B-Mode imaging findings, and CEUS grades between the two groups were analyzed.

Results: Among the 90 GCA patients, 44 were in the active phase and 46 were in the inactive phase. There were significant differences in C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and CEUS grades between the two groups (p < 0.001). There were no significant differences in gender, age, body mass index (BMI), monocyte count, platelet count, IMT, or the diameter of the temporal artery between the two groups (p > 0.05). When using CEUS grade ≥ 2 as the criterion for the diagnosis of active GCA, the sensitivity was 93.18%, specificity was 63.04%, and overall diagnostic accuracy was 77.78%. CEUS grades were positively correlated with CRP and ESR among the 90 GCA patients (r = 0.741 and 0.853, p < 0.05). In the active group, CRP and ESR levels significantly decreased after anti-inflammatory treatment (p < 0.001), while IMT and the diameter of the temporal artery showed no significant changes (p > 0.05).

Conclusion: CEUS could accurately evaluate the clinical phase and severity of inflammation in GCA, and provide valuable information for timely clinical adjustment of treatment regimens.