Ultrasonographic changes of major salivary glands in primary Sjogren's syndrome. Diagnostic value of a novel scoring system
Ultrasonographic changes of major salivary glands in primary Sjogren's syndrome. Diagnostic value of a novel scoring system
复制标题
DOI：
10.1093/rheumatology/keh588
复制
发表时间：
2005-06-01
期刊：
影响因子：
5.5
通讯作者：
Tomsic, M
中科院分区：
文献类型：
--
作者：
Hocevar, A;Ambrozic, A;Tomsic, M
目标.揭示干燥综合征（SS）相关的大涎腺典型超声（US）改变，并确定新的US评分系统的诊断价值。在218例疑似SS的连续患者中，除了遵循2002年美国-欧洲共识组标准的常规诊断程序外，还进行了腮腺和颌下唾液腺的US检查。评估了5个超声参数：回声强度、不均匀性、低回声区数量、高回声反射和唾液腺边界清晰度。对所有四个唾液腺的这五个参数的等级进行求和。最终US评分范围为0 ~ 48分。68例患者建立了SS。其余150例未确诊SS的受试者构成我们的对照组。所有5个US参数均与SS显著相关。SS患者的超声评分明显高于非SS患者（P < 0.01）。将超声评分的临界值设为17分，特异性（98.7%）与敏感性（58.8%）之比最佳。在我们的新评分系统中总结的大唾液腺中定义明确的US变化是SS患者的典型特征。在US成像上发现的高级结构改变几乎总是代表SS唾液腺受累。
Objectives. To reveal typical ultrasonographic (US) changes in major salivary glands associated with Sjogren's syndrome (SS) and to determine the diagnostic value of a novel US scoring system.Methods. In 218 consecutive patients with suspected SS, US of both parotid and submandibular salivary glands was performed besides the regular diagnostic procedure following the American-European Consensus Group criteria of 2002. Five US parameters were assessed: echogenicity, inhomogeneity, number of hypoechogenic areas, the hyperechogenic reflections and clearness of the borders of the salivary gland. The grades of these five parameters for all four salivary glands were summed. The final US score ranged from 0 to 48.Results. SS was established in 68 patients. The remaining 150 subjects, in whom SS was not confirmed, constituted our control group. All five US parameters were significantly associated with SS. The patients with SS had significantly higher US scores than those not diagnosed with SS (P < 0.01). Setting the cut-off US score at 17 resulted in the best ratio of specificity (98.7%) to sensitivity (58.8%).Conclusions. Well-defined US changes in the major salivary glands summarized in our novel scoring system were typical of SS patients. Advanced structural changes found on US imaging almost invariably represent SS salivary gland involvement.