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FRI0518 Ultrasound Definitions for Vasculitis in Cranial and Large Vessel Giant Cell Arteritis: Results of A Delphi Survey of The Omeract Ultrasound Large Vessel Vasculitis Group
  1. C. Duftner1,
  2. C. Dejaco2,
  3. U. Moller Dohn3,
  4. G.A. Bruyn4,
  5. S. Chrysidis5,
  6. M.A. D'Agostino6,
  7. B. Dasgupta7,
  8. E. de Miguel8,
  9. A.P. Diamantopoulos9,
  10. P. Hanova10,
  11. W. Hartung11,
  12. A. Iagnocco12,
  13. T.A. Kermani13,
  14. M.J. Koster14,
  15. P. Macchioni15,
  16. M. Milchert16,
  17. C. Mukhtyar17,
  18. E. Naredo18,
  19. C. Ponte19,
  20. N. Rastalsky20,
  21. V.S. Schäfer21,
  22. L. Terslev3,
  23. K.J. Warrington14,
  24. W.A. Schmidt21
  1. 1Medical University Innsbruck, Innsbruck
  2. 2Medical University Graz, Graz, Austria
  3. 3Center for Rheumatology and Spine Diseases and COPECARE, Glostrup, Denmark
  4. 4MC Groep Hospitals, Lelystad, Netherlands
  5. 5Esbjerg Hospital, Esbjerg, Denmark
  6. 6Université Versailles St-Quentin, Boulogne-Billancourt, France
  7. 7Southend University Hospital, Southend, United Kingdom
  8. 8University Hospital La Paz, Madrid, Spain
  9. 9Hospital for Rheumatic Diseases, Haugesund, Norway
  10. 10Charles University, Prague, Czech Republic
  11. 11Asklepios Medical Center Bad Abbach, Bad Abbach, Germany
  12. 12Sapienza Università di Roma, Rome, Italy
  13. 13University of California, Los Angeles
  14. 14Mayo Clinic, Rochester, United States
  15. 15Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
  16. 16Pomeranian Medical University, Szczecin, Poland
  17. 17Norfolk and Norwich University Hospital, Norwich, United Kingdom
  18. 18Hospital General Universitario Gregorio Marañόn, Madrid, Spain
  19. 19Lisbon Academic Medical Centre, Lisbon, Portugal
  20. 20St. Elizabeth's Medical Center, Boston, United States
  21. 21Immanuel Krankenhaus Berlin-Buch, Berlin, Germany

Abstract

Background In a systematic literature review (SLR), we identified halo sign, stenosis, occlusion, compression sign and a decreased vessel wall pulsation as elementary ultrasound (US) lesions in giant cell arteritis (GCA).

Objectives To establish consensus-based definitions for the key elementary US lesions in GCA.

Methods We invited 25 rheumatologists from 13 countries experienced in musculoskeletal and vascular US to participate in a Delphi exercise. Based on the results from the SLR and international expert consensus a questionnaire was developed including 12 statements on the definitions of normal temporal and extra-cranial large arteries, arteriosclerosis, halo sign, stenosis, occlusion, compression sign, and vessel wall pulsation. The experts were asked to express their level of agreement or disagreement with the proposed statements. A consensus was defined as agreement of ≥75% of participants.

Results The response rate was 24/25 (96%) in round 1 and 24/24 (100%) in round 2. A consensus was achieved for 9/9 Delphi statements [normal temporal and extra-cranial large arteries, arteriosclerosis, halo sign, stenosis of temporal and extra-cranial large arteries, occlusion, compression sign (temporal arteries), US assessment of compression sign (temporal arteries) in round 1. In round 2, 3/3 Delphi statements (arteriosclerosis, halo sign, stenosis of temporal arteries) were redefined. The statements on vessel wall pulsation (definition and assessment) and measurement of vessel wall thickness did not reach the threshold for consensus. The halo and compression signs were deemed to be the most important US signs for GCA with 100% and 83.3% expert agreement, respectively.

Conclusions This is the first international consensus on definitions for elementary US lesions in GCA. The next steps of the OMERACT project will be web- and patients based exercises testing the reliability of the new definitions.

Disclosure of Interest None declared

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