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超声弹性成像在评估原发性干燥综合征涎腺受累情况中的应用

Ultrasound elastography in assessment of salivary glands involvement in primary Sjögren's syndrome.

作者信息

Cindil Emetullah, Oktar Suna Ozhan, Akkan Koray, Sendur Halit Nahit, Mercan Rıdvan, Tufan Abdurrahman, Ozturk Mehmet Akif

机构信息

Gazi University Faculty of Medicine, Department of Radiology, Ankara, Turkey.

Gazi University Faculty of Medicine, Department of Radiology, Ankara, Turkey.

出版信息

Clin Imaging. 2018 Jul-Aug;50:229-234. doi: 10.1016/j.clinimag.2018.04.011. Epub 2018 Apr 14.

Abstract

OBJECTIVE

Our study aimed to assess the pathological sonoelastographic changes in the major salivary glands and to demonstrate the diagnostic effectiveness of Sonoelastography as an additional method to US in Sjögren's syndrome.

METHODS

Fifty eight patients with primary Sjögren's syndrome (pSS) were selected according to the American-European Consensus Group Classification criteria. Twenty five healthy volunteers involved in this study. All patients were evaluated with B-mode and elastography by using Hitachi EUB 7500 digital ultrasound equipment. All subjects were female. The sonoelastography examination, which allowed us to assess the elasticity of the parenchyma, was performed and strain ratios were measured by comparing with the adjacent tissues.

RESULTS

Statistically significant differences were found between the pSS and control groups for the elastographic scores and strain ratios (p < 0.001). The highest sensitivity and specificity levels were obtained when the strain ratio cut-off value was taken as 1.55 for the submandibular gland and 2.45 for the parotid gland (sensitivity and specificity were 83% and 88% respectively for the submandibular gland and 83% and 92% respectively for the parotid gland). However, no statistically significant differences were found between the disease duration and the elasticity scores or strain ratios in pSS group (p > 0.05).

CONCLUSION

US examination is an efficient method to assess major salivary gland involvement in the diagnosis of pSS. Sonoelastography is a modality which can contribute to the diagnosis by improving specificity in the differential diagnosis of pSS. Strain ratio measurement, which is a semi-quantitative method, increases the diagnostic effectiveness by providing high sensitivity, specificity, and negative predictive values.

摘要

目的

本研究旨在评估大唾液腺的病理弹性成像变化,并证明弹性成像作为干燥综合征中超声检查的辅助方法的诊断有效性。

方法

根据欧美共识小组分类标准,选取58例原发性干燥综合征(pSS)患者。25名健康志愿者参与本研究。所有患者均使用日立EUB 7500数字超声设备进行B超和弹性成像评估。所有受试者均为女性。进行了弹性成像检查,通过与相邻组织比较来评估实质弹性,并测量应变率。

结果

pSS组与对照组在弹性成像评分和应变率方面存在统计学显著差异(p<0.001)。当将下颌下腺的应变率临界值设为1.55,腮腺的应变率临界值设为2.45时,获得了最高的敏感性和特异性水平(下颌下腺的敏感性和特异性分别为83%和88%,腮腺的敏感性和特异性分别为83%和92%)。然而,pSS组的病程与弹性评分或应变率之间未发现统计学显著差异(p>0.05)。

结论

超声检查是评估pSS诊断中主要唾液腺受累情况的有效方法。弹性成像通过提高pSS鉴别诊断的特异性,有助于诊断。应变率测量作为一种半定量方法,通过提供高敏感性、特异性和阴性预测值,提高了诊断有效性。

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