Kami Yukiko N, Sumi Misa, Takagi Yukinori, Sasaki Miho, Uetani Masataka, Nakamura Takashi
Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, Nagasaki, Japan.
Department of Radiology, Nagasaki University Graduate School of Biosciences, Nagasaki, Japan.
PLoS One. 2016 Mar 9;11(3):e0150680. doi: 10.1371/journal.pone.0150680. eCollection 2016.
Sjögren's syndrome (SS) is characterized by hypofunction of the salivary and lacrimal glands. The salivary function is largely dependent upon the blood supply in the glands. However, the diseased states of the gland perfusion are not well understood. The arterial spin labeling (ASL) technique allows noninvasive quantitative assessment of tissue perfusion without the need for contrast agent. Here, we prospectively compared the perfusion properties of the parotid glands between patients with SS and those with healthy glands using ASL MR imaging. We analyzed salivary blood flow (SBF) kinetics of 22 healthy parotid glands from 11 volunteers and 28 parotid glands from 14 SS patients using 3T pseudo-continuous ASL imaging. SBF was determined in resting state (base SBF) and at 3 sequential segments after gustatory stimulation. SBF kinetic profiles were characterized by base SBF level, increment ratio at the SBF peak, and the differences in segments where the peak appeared (SBF types). Base SBFs of the SS glands were significantly higher than those of healthy glands (59.2 ± 22.8 vs. 46.3 ± 9.0 mL/min/100 g, p = 0.01). SBF kinetic profiles of the SS glands also exhibited significantly later SBF peaks (p < 0.001) and higher SBF increment ratios (74 ± 49% vs. 47 ± 39%, p = 0.04) than the healthy glands. The best SBF criterion (= 51.2 mL/min/100 mg) differentiated between control subjects and SS patients with 71% sensitivity and 82% specificity. Taken together, these results showed that the SS parotid glands were mostly hyperemic and the SS gland responses to gustatory stimulation were stronger and more prolonged than those of the healthy glands. The ASL may be a promising technique for assessing the diseased salivary gland vascularization of SS patients.
干燥综合征（SS）的特征是唾液腺和泪腺功能减退。唾液功能在很大程度上依赖于腺体的血液供应。然而，腺体灌注的病变状态尚未得到很好的理解。动脉自旋标记（ASL）技术无需使用造影剂即可对组织灌注进行无创定量评估。在此，我们使用ASL磁共振成像前瞻性地比较了SS患者与健康腺体患者腮腺的灌注特性。我们使用3T伪连续ASL成像分析了11名志愿者的22个健康腮腺和14名SS患者的28个腮腺的唾液血流（SBF）动力学。在静息状态（基础SBF）和味觉刺激后的3个连续时间段测定SBF。SBF动力学曲线的特征在于基础SBF水平、SBF峰值时的增加率以及峰值出现的时间段差异（SBF类型）。SS腺体的基础SBF显著高于健康腺体（59.2±22.8 vs. 46.3±9.0 mL/min/100 g，p = 0.01）。与健康腺体相比，SS腺体的SBF动力学曲线还表现出显著更晚的SBF峰值（p < 0.001）和更高的SBF增加率（74±49% vs. 47±39%，p = 0.04）。最佳的SBF标准（= 51.2 mL/min/100 mg）区分对照组和SS患者的敏感性为71%，特异性为82%。综上所述，这些结果表明SS腮腺大多充血，且SS腺体对味觉刺激的反应比健康腺体更强且更持久。ASL可能是评估SS患者患病唾液腺血管化的一种有前景的技术。
