Decuzzi Marco, Tatulli Francesca, Giampaolo Maria, Tesse Riccardina, Gasparre Marianna, Pepe Giovanna, Decuzzi Paolo, Asteriadis Ioannis
Nuclear Medicine Policlinico, Bari, Italy.
Hell J Nucl Med. 2006 May-Aug;9(2):103-5.
Sjögren's syndrome (SjS) is an autoimmune disease characterized by distraction of particularly salivary and lacrimal glands. The aim of the present study was to compare salivary gland scintigraphy (SGS) and salivary gland ultrasonography (SUS) in identifying salivary gland function in patients first diagnosed with SjS. We recruited 20 such patients with SjS (5 male, 15 female, aged from 35 to 65 y, mean age 52, standard deviation: +/-5 y. All patients were submitted to SUS and SGS longitudinal and transverse images. Before the scintiscan, patients fasted for 6 h. Technetium-99m pertechnetate ((99m)Tc-PT) 110 MBq was injected intravenously (i.v.) and simultaneous multi-frames dynamic acquisition was performed for 30 min. In two patients who had discordant results between SUS and US, labial biopsy was performed. Dynamic acquisition curves for 30 sec for the parotid and the submandibular glands were generated. For each gland we have calculated: (a) the maximum uptake (MU): the ratio between the mean counts in the gland at 20 min and the background activity and (b) the outflow efficiency (OE): the ratio between the minimum counts after lemon juice stimulation at 30 min and the counts at 20 min. The results showed abnormal scintiscans with low MU and high OE in one or more of the glands, in 17/20 patients. These results were confirmed by SUS in 15 cases and in two cases labial biopsy confirmed the diagnosis made by SGS while SUS was negative. In the remaining 3/20 cases of SjS both tests, SUS and SGS, showed normal results. Discrepancies between SGS findings and labial biopsy as found in two of our cases have been reported by others and may be due among other causes to early lymphocytic infiltration in SjS. Normal findings of SGS have also been reported. In conclusion, in cases first diagnosed with SjS, the function of the parotid and the submandibular glands was better identified by the SGS as compared to SUS. Although SGS is a more complex and expensive examination, it should be preferred to SUS as more sensitive and indicating the stage of SjS.
干燥综合征（SjS）是一种自身免疫性疾病，其特征是特别是唾液腺和泪腺受到损害。本研究的目的是比较唾液腺闪烁扫描（SGS）和唾液腺超声检查（SUS）在初诊为SjS的患者中识别唾液腺功能的情况。我们招募了20例此类SjS患者（5例男性，15例女性，年龄35至65岁，平均年龄52岁，标准差：±5岁）。所有患者均接受了SUS和SGS的纵向和横向图像检查。在闪烁扫描前，患者禁食6小时。静脉注射（i.v.）99m锝高锝酸盐（（99m）Tc-PT）110 MBq，并进行30分钟的同步多帧动态采集。对两名SUS和US结果不一致的患者进行了唇腺活检。生成了腮腺和颌下腺30秒的动态采集曲线。对于每个腺体，我们计算了：（a）最大摄取量（MU）：20分钟时腺体平均计数与背景活性的比值；（b）流出效率（OE）：30分钟柠檬汁刺激后最小计数与20分钟时计数的比值。结果显示，17/20的患者中一个或多个腺体的闪烁扫描结果异常，MU低且OE高。15例患者的SUS结果证实了这些结果，2例患者唇腺活检证实了SGS的诊断，而SUS为阴性。在其余3/20的SjS病例中，SUS和SGS两项检查结果均正常。我们的两个病例中发现的SGS结果与唇腺活检之间的差异已被其他人报道，可能是由于SjS早期淋巴细胞浸润等其他原因。也有SGS正常结果的报道。总之，在初诊为SjS的病例中，与SUS相比，SGS能更好地识别腮腺和颌下腺的功能。虽然SGS是一种更复杂、更昂贵的检查，但由于其更敏感且能指示SjS的阶段，应优先于SUS使用。
