Validity of high resolution magnetic resonance imaging in detecting giant cell arteritis: a meta-analysis

• Published in: European radiology Vol. 32; no. 5; pp. 3541 - 3552
• Main Authors: Zhang, Ke-Jia, Li, Ming-Xi, Zhang, Peng, Qin, Hai-Qiang, Guo, Zhen-Ni, Yang, Yi
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-05-2022; Springer Nature B.V
• Subjects: Abnormalities; Arteries; Arteritis; Biopsy; Diagnosis; Diagnostic Radiology; Giant Cell Arteritis - diagnostic imaging; Giant Cell Arteritis - pathology; Head and Neck; Heterogeneity; High resolution; Humans; Image resolution; Imaging; Internal Medicine; Interventional Radiology; Ischemia; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Medical imaging; Medicine; Medicine & Public Health; Meta-analysis; Neuroradiology; Optic Nerve - pathology; Optic neuropathy; Performance evaluation; Quality assessment; Quality control; Radiology; Resonance; Sensitivity; Sensitivity and Specificity; Temporal Arteries - pathology; Ultrasound; Vein & artery diseases; Magnetic resonance imaging; Giant cell arteritis; Optic neuropathy, Ischemic
• ISSN: 1432-1084; 0938-7994; 1432-1084
• DOI: 10.1007/s00330-021-08413-8

Objectives
This study was designed to evaluate the performance of high-resolution magnetic resonance imaging (HR-MRI) in detecting giant cell arteritis (GCA), evaluate superficial extracranial artery and other MRI abnormalities, and compare three-dimensional (3D) and two-dimensional (2D) techniques.
Methods
PubMed, Web of Science, and Cochrane Library were screened up to March 7, 2021, and further selection was performed according to the eligibility criteria. Quality Assessment of Diagnostic Accuracy Studies-2 was used for quality assessment, and heterogeneity assessment and statistical calculations were also performed.
Results
In total, 1851 records were retrieved from online databases, and 15 studies were finally included. Regarding the performance of HR-MRI, the superficial extracranial artery had 75% sensitivity and 89% specificity, respectively, with an area under the receiver operating characteristic curve (AUC) of 0.91. Positive and negative post-test possibilities were 86% and 20%, respectively, with clinical diagnosis as reference. When referenced with temporal artery biopsy, the sensitivity was 91%, specificity was 78%, AUC was 0.92, and positive and negative post-test possibilities were 78% and 10%, respectively. 3D HR-MRI and 2D HR-MRI had 70% and 72% sensitivity, respectively, and 91% and 84% specificity, respectively.
Conclusions
HR-MRI is a valuable imaging modality for GCA diagnosis. It provided high accuracy in the diagnosis of GCA and played a potential role in identifying GCA-related ischemic optic neuropathy. 3D HR-MRI had better specificity than 2D HR-MRI.
Key Points
HR-MRI helps clinicians to diagnose GCA
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Superficial extracranial arteries and other MRI abnormalities can be assessed with HR-MRI
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HR-MRI can help in assessing GCA-related optic neuropathy
.