Carotti M, Salaffi F, Manganelli P, Argalia G
Department of Radiology, University of Ancona, Italy.
Clin Rheumatol. 2001;20(3):213-9. doi: 10.1007/s100670170068.
To examine either the ultrasonographic (US) features of the parotids and submandibular glands or the blood flow alterations that may occur in the salivary glands of patients with primary Sjögren's syndrome (pSS) we studied 30 female patients with pSS and 30 controls suffering from dry mouth not due to pSS. All measurements were taken by the same examiner, who used the same equipment to avoid interobserver variability. The US parameters recorded (parenchymal homogeneity, echogenicity, size of the glands and posterior glandular border) were scored according to a previously described scoring system. For each waveform, peak systolic velocity (PSV) and resistive index (RI) were measured at the external carotid artery in the examination of the parotids and at the facial artery within the submandibular glands before and during lemon juice stimulation. On the basis of the degree of chronic inflammatory changes at minor salivary gland (MSG) biopsy, chronic sialadenitis (CS) was defined as mild in 10 and severe in 20 pSS patients. Abnormal US scores were obtained in 26/30 (86.6%) pSS patients and in 9/30 (30%) controls. Moreover, in pSS patients the US scores were sigificantly higher than in the control group (p=-0.0001). The mean (+/- SD) difference between the PSV values taken from parotids and submandibular glands before and during lemon juice stimulation was statistically significant (p=0.003 and p=0.01, respectively) in the controls. On the other hand, no significant changes in the PSV values were found in the whole group of pSS patients. However, the changes in PSV values before and during lemon juice stimulation were statistically significant in both parotids (p=0.019) and submandibular glands (p=0.012), and not significantly different from those in the controls in pSS patients with mild CS. The variability of RI taken from the salivary glands before and during lemon juice stimulation was not statistically significant in either pSS patients or controls. US abnormalities were detected in the majority of pSS patients and their severity was significantly greater than those recorded in the controls. Of the colour Doppler sonographic (CDS) parameters only PSV was influenced by the degree of chronic inflammation, as shown at the MSG biopsy, suggesting that PSV may reflect the vascular changes occurring in the salivary glands during the course of an autoimmune disease such as pSS.
为了研究原发性干燥综合征（pSS）患者腮腺和颌下腺的超声（US）特征，以及唾液腺可能发生的血流变化，我们对30例pSS女性患者和30例非pSS所致口干的对照者进行了研究。所有测量均由同一名检查者进行，其使用相同的设备以避免观察者间的差异。根据先前描述的评分系统对记录的US参数（实质均匀性、回声性、腺体大小和腺体后缘）进行评分。对于每个波形，在腮腺检查时于颈外动脉处以及颌下腺内的面动脉处，在柠檬汁刺激前后测量收缩期峰值速度（PSV）和阻力指数（RI）。根据小唾液腺（MSG）活检的慢性炎症变化程度，将10例pSS患者的慢性涎腺炎（CS）定义为轻度，20例定义为重度。30例pSS患者中有26例（86.6%）获得异常US评分，30例对照者中有9例（30%）获得异常评分。此外，pSS患者的US评分显著高于对照组（p = -0.0001）。对照组中，柠檬汁刺激前后腮腺和颌下腺PSV值的平均（±标准差）差异具有统计学意义（分别为p = 0.003和p = 0.01）。另一方面，整个pSS患者组中未发现PSV值有显著变化。然而，柠檬汁刺激前后PSV值的变化在腮腺（p = 0.019）和颌下腺（p = 0.012）中均具有统计学意义，并且在轻度CS的pSS患者中与对照组的变化无显著差异。柠檬汁刺激前后唾液腺RI的变异性在pSS患者或对照组中均无统计学意义。在大多数pSS患者中检测到US异常，其严重程度显著高于对照组记录的异常。如MSG活检所示，在彩色多普勒超声（CDS）参数中，只有PSV受慢性炎症程度的影响，这表明PSV可能反映了诸如pSS等自身免疫性疾病过程中唾液腺发生的血管变化。
