Die Duplexsonografie in der Diagnostik der Riesenzellarteriitis

Zusammenfassung

Aufgrund ihrer hohen Inzidenz und des hohen Risikos für Erblindung und Apoplexie muss die Diagnose einer Riesenzellarteriitis rasch gestellt werden. Bei entsprechender klinischer Konstellation mit temporalen Kopfschmerzen, Kauclaudicatio, plötzlichem Visusverlust, Polymyalgia-rheumatica-Symptomatik und konstitutionellen Symptomen ist es mithilfe der Duplexsonografie in der Regel möglich, die Erkrankung zu diagnostizieren. Typische sonografische Befunde als Ausdruck der Gefäßwandinflammation sind echoarme Intima-Media-Verdickungen, Haloformationen, ein positives Kompressionszeichen sowie Stenosen und Vasookklusionen. Dabei kann die Duplexsonografie in geübten Händen hinsichtlich Sensitivität und Spezifität problemlos mit der Temporalisbiopsie, PET/CT und MRT konkurrieren. Mit der vorliegenden Arbeit möchten wir die aktuelle Datenlage zur Duplexsonografie darlegen und praktische Hinweise für die Anwendung im Alltag liefern.

Abstract

Due to its high incidence and its high risk for blindness and stroke, giant-cell arteritis must be diagnosed quickly. In the context of typical clinical features such as temporal headaches, jaw claudication, acute onset of loss of vision, polymyalgia rheumatica and constitutional symptoms, the diagnosis can be made by duplex sonography. Typical sonographic findings pointing to vessel wall inflammation include hypoechoic thickening of the intima-media complex, halo formation, a positive compression sign, stenosis and vessel occlusion. In the hands of a well-trained sonographer, duplex sonography can easily compete with temporal artery biopsy, PET/CT and MRI in terms of sensitivity and specificity. In the following article, we have summarised the current data available on duplex sonography and provided practical hints for everyday application.

Schlüsselwörter

Arteriitis temporalis - Riesenzellarteriitis - Duplexsonografie - Ultraschall - Großgefäßvaskulitis

Key words

duplex sonography - giant-cell arteritis - temporal arteritis - ultrasound - large vessel vasculitis

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