ACR Open Rheumatology · Published 2026-05-01 · DOI 10.1002/acr2.90066
Objective There is a need for measures of disease severity for giant cell arteritis (GCA), which may enable identification of high‐risk subgroups (eg, ophthalmic complications) and individualized approaches to therapy. We derived a continuous score using data from cranial vessel wall magnetic resonance imaging (VW‐MRI) to quantify vascular burden in GCA and assessed the score's association with ophthalmic manifestations. Methods Patients with suspected new or relapsing GCA underwent cranial VW‐MRI plus dedicated orbital MRI. A radiologist assessed VW‐MRI enhancement of seven cranial structures bilaterally. Using a generalized linear mixed‐effects model, a continuous MRI‐derived patient‐level score (range 1–10) of disease extent was developed: the Cranial Artery MRI Score for GCA (CAMRIS‐GCA). CAMRIS‐GCA was compared between clinical diagnosis (ocular GCA, nonocular GCA, or non‐GCA) and patients with versus without ocular inflammation on MRI (defined as ophthalmic artery or optic nerve sheath enhancement). Results Seventy‐four patients (17 ocular GCA, 16 nonocular GCA, and 41 non‐GCA) were included. CAMRIS‐GCA increased linearly across clinically defined groups of non‐GCA, nonocular GCA, and ocular GCA (CAMRIS‐GCA median 0.6 [interquartile range (IQR) 0–1.7] vs median 2.5 [IQR 0.5–6.6] vs median 4.8 [IQR 2.1–8.5]; P < 0.01). Patients with orbital inflammation on MRI (with or without visual symptoms) had a higher median CAMRIS‐GCA compared to patients with negative orbital MRI (median 6.7 [IQR 5.6–8.5] vs median 0.4 [IQR 0–1.6]; P < 0.01). Conclusion This proof‐of‐concept study introduces a quantitative MRI‐derived vascular burden score in GCA and demonstrates its association with ophthalmic involvement. These early findings suggest that cranial VW‐MRI may offer a prognostic value in identifying patients at risk for vision‐threatening disease.
Abstract from DOAJ. Public domain (CC0 1.0).
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