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MRI displays involvement of the temporalis muscle and the deep temporal artery in patients with giant cell arteritis

  • Magnetic Resonance
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Abstract

Purpose

To assess deep temporal artery and temporalis muscle involvement in patients with giant cell arteritis (GCA).

Material and methods

Ninety-nine patients who received magnetic resonance imaging (MRI) and superficial temporal artery biopsy (TAB) were included in this study. Patients with positive TAB (n = 61) were defined as GCA patients, those with negative TAB (n = 38) as the GCA-negative reference group. Contrast-enhanced T1w-images were acquired utilizing 1.5 T and 3 T MRI. Two radiologists assessed the images. Mural contrast-hyperenhancement and wall thickening of the deep temporal artery and hyperenhancement of the muscle were defined as inflammation. MRI results were correlated with jaw claudication in 70 patients.

Results

The two observers found temporalis muscle involvement in 19.7 % (n = 12) and 21.3 % (n = 13) of GCA patients. It occurred bilaterally in 100 %. Specificities were 92/97 % and sensitivities were 20/21 %. Deep temporal artery involvement was found in 34.4 % (n = 21) and 49.2 % (n = 30) and occurred bilaterally in 80/90.5 %. Specificities were 84/95 % and sensitivities were 34/49 %. Both structures were affected simultaneously in 18/21.3 %. Jaw claudication correlated moderately with inflammation of the temporalis muscle (r = 0.31; p < 0.05) and the deep temporal artery (r = 0.38; p = 0.01).

Conclusion

MRI visualizes changes in the temporalis muscle and the deep temporal artery in GCA. Moderate correlation of clinical symptoms with MRI results was observed.

Key Points

• Approximately 20 % of GCA patients presented with temporalis muscle inflammation.

• A total of 34-49 % of GCA patients presented with vasculitis of the deep temporal artery.

• In approximately 20 % of GCA patients, both structures were simultaneously involved.

• Involvement of both structures correlated moderately with presence of jaw claudication.

• MRI is a suitable tool for the assessment of vasculitis and muscle inflammation.

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Acknowledgements

The scientific guarantor of this publication is Professor Dr. med. Thorsten A. Bley. The authors of this manuscript declare relationships with the following companies: Thorsten Bley: Payment for lectures (past) - Bayer, Bracco, Guerbet. Thomas Neß: Consultancy (current) - Sanofi, Santen, Novartis, Expert testimony (past) - Novartis. MRI contrast agents of the above-mentioned companies were used. The authors of this manuscript declare no other relationships with any companies, whose products or services may be related to the subject matter of the article. This study has received funding by DFG. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. No study subjects or cohorts have been previously reported. Methodology: prospective, diagnostic study, multi-center study.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Medical Center Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany

    Simon Veldhoen & Thorsten A. Bley

  2. Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital - University Medical Center Bern, Bern, Switzerland

    Thorsten Klink

  3. Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Freiburg, Germany

    Julia Geiger

  4. Division of Radiology, University Children’s Hospital Zürich, Zürich, Switzerland

    Julia Geiger

  5. Department of Rheumatology and Immunology, University Medical Center Freiburg, Freiburg, Germany

    Peter Vaith & Cornelia Glaser

  6. Department of Ophthalmology, University Medical Center Freiburg, Freiburg, Germany

    Thomas Ness

  7. Department of Ophthalmology, University Medical Center Kiel, Kiel, Germany

    Dirk Duwendag

  8. Department of Diagnostic and Interventional Radiology, University Medical Center Kiel, Kiel, Germany

    Marcus Both

Authors
  1. Simon Veldhoen
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  2. Julia Geiger
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  3. Peter Vaith
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  4. Cornelia Glaser
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  5. Thomas Ness
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  7. Marcus Both
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  8. Thorsten A. Bley
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Correspondence to Simon Veldhoen.

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Veldhoen, S., Klink, T., Geiger, J. et al. MRI displays involvement of the temporalis muscle and the deep temporal artery in patients with giant cell arteritis. Eur Radiol 24, 2971–2979 (2014). https://doi.org/10.1007/s00330-014-3255-1

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  • DOI: https://doi.org/10.1007/s00330-014-3255-1

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