title: Effects of early corticosteroid treatment on magnetic resonance imaging and ultrasonography findings in giant cell arteritis.
abstract: OBJECTIVE
  To compare the impact of initial corticosteroid treatment on high-resolution MRI and colour-coded duplex sonography (CCDS) findings in patients with GCA (temporal).
  
  
  METHODS
  Sensitivity and specificity of CCDS and high-resolution contrast-enhanced MRI studies of 59 patients with suspected GCA were retrospectively analysed. Patients were grouped according to the duration of steroid treatment before imaging: 0-1 day, 2-4 days and >4 days. In 41 patients, imaging results were compared with findings of temporal artery biopsy (TAB).
  
  
  RESULTS
  Sixty-one per cent (36/59) of patients were diagnosed with GCA. TAB findings were positive in 59% (24/41). The compared results of TAB sensitivity of CCDS and MRI under steroid treatment of 0-1 day were 92% and 90%, 2-4 days 80% and 78% and >4 days 50% and 80%, respectively. The compared results of the final clinical diagnosis sensitivity of CCDS and MRI under steroid treatment of 0-1 day was 88% and 85%, 2-4 days 50% and 64% and >4 days 50% and 56%, respectively.
  
  
  CONCLUSIONS
  Sensitivity of a first-time CCDS or an MRI for detection of GCA rapidly decreases under corticosteroid treatment. Therefore imaging of patients with suspected GCA should be performed as soon as possible, preferably within the first days of treatment.
authors: Department of Diagnostic and Interventional Radiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors: Carolin
authors: C
authors: Hauenstein
authors: Matthias
authors: M
authors: Reinhard
authors: Julia
authors: J
authors: Geiger
authors: Michael
authors: M
authors: Markl
authors: Andreas
authors: A
authors: Hetzel
authors: Andras
authors: A
authors: Treszl
authors: Peter
authors: P
authors: Vaith
authors: Thorsten A
authors: TA
authors: Bley
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000368:Aged; D005260:Female; D013700:Giant Cell Arteritis / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color
chemical_list: D000305:Adrenal Cortex Hormones