Hocevar A, Ambrozic A, Rozman B, Kveder T, Tomsic M
Department of Rheumatology, University Clinical Centre, Vodnikova 62, 1000 Ljubljana, Slovenia.
Rheumatology (Oxford). 2005 Jun;44(6):768-72. doi: 10.1093/rheumatology/keh588. Epub 2005 Mar 1.
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.
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.
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%).
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.
揭示与干燥综合征（SS）相关的主要唾液腺典型超声（US）变化，并确定一种新型US评分系统的诊断价值。
在218例疑似SS的连续患者中，除按照2002年欧美共识小组标准进行常规诊断程序外，还对腮腺和下颌下唾液腺进行了超声检查。评估了五个US参数：回声性、不均匀性、低回声区数量、高回声反射以及唾液腺边界清晰度。将所有四个唾液腺这五个参数的等级相加。最终US评分范围为0至48分。
68例患者确诊为SS。其余150例未确诊为SS的受试者构成我们的对照组。所有五个US参数均与SS显著相关。SS患者的US评分显著高于未诊断为SS的患者（P<0.01）。将US评分临界值设定为17时，特异性（98.7%）与敏感性（58.8%）的比例最佳。
我们新型评分系统总结的主要唾液腺明确的US变化是SS患者的典型表现。US成像发现的晚期结构变化几乎总是代表SS唾液腺受累。
