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干燥综合征患者涎腺动态磁共振造影定量分析。

Quantitative Analysis of Parotid Gland Secretion Function in Sjögren's Syndrome Patients with Dynamic Magnetic Resonance Sialography.

机构信息

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Rheumatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Korean J Radiol. 2019 Mar;20(3):498-504. doi: 10.3348/kjr.2018.0508.

Abstract

OBJECTIVE

To evaluate the secretory function of parotid glands by dynamic magnetic resonance (MR) sialography and determine the clinical performance of this technique in diagnosing and evaluating Sjögren's syndrome (SS) patients.

MATERIALS AND METHODS

This study enrolled 29 healthy volunteers (25 women and 4 men; mean age, 34.8 ± 6.3 years; age range, 26-47 years) and 25 primary SS (pSS) patients (23 women and 2 men; mean age, 37.7 ± 7.9 years; age range, 25-50 years) with decreased secretory function. The volume of the parotid gland ducts was precisely measured for both groups at single pre- and 6 post-gustatory-stimulated phases. Time-dependent volume change ratio curves were generated, four parameters were derived from the curves: the slope of the increase in the first post-stimulation phase (slope), the peak value, the time-to-peak, the total saliva secretion post-stimulation. All values were used to quantitatively evaluate the secretory function of the parotid gland. The repeated measurement analysis, Mann-Whitney U test and receiver operating characteristic curve were applied.

RESULTS

Time-dependent volume change ratio curves demonstrated that there is a statistically significant difference between the two groups (F = 8.750; = 0.005). A quickly increasing curve was shown in the volunteer group, whereas a slowly increasing curve was shown in the pSS patient group. The slope1st, peak value and total saliva secretion post-stimulation of the patient group were significantly lower than those of the volunteer group ( = 0.005, = 0.003, and = 0.002, respectively). The time-to-peak between the two groups was not significantly different ( = 0.383). The slope1st can be used as a discriminator to diagnose SS patients ( = 0.015; odds ratio = 4.234; area under the curve = 0.726).

CONCLUSION

Dynamic MR sialography is proven to be an effective method in evaluating salivary gland function and has a great potential in diagnosing and evaluating pSS patients.

摘要

目的

通过动态磁共振唾液腺造影评估腮腺的分泌功能,并确定该技术在诊断和评估干燥综合征(SS)患者中的临床性能。

材料与方法

本研究纳入 29 名健康志愿者(25 名女性和 4 名男性;平均年龄 34.8 ± 6.3 岁;年龄范围 26-47 岁)和 25 名原发性 SS(pSS)患者(23 名女性和 2 名男性;平均年龄 37.7 ± 7.9 岁;年龄范围 25-50 岁),这些患者均存在分泌功能减退。对两组志愿者在单次预刺激和 6 次味觉刺激后相的腮腺导管体积进行精确测量。生成时间依赖性体积变化比曲线,从曲线中得出 4 个参数:第 1 次刺激后相增加的斜率(斜率)、峰值、达峰时间、刺激后总唾液分泌量。所有值均用于定量评估腮腺的分泌功能。采用重复测量分析、Mann-Whitney U 检验和受试者工作特征曲线。

结果

时间依赖性体积变化比曲线显示两组间存在统计学差异(F = 8.750; = 0.005)。志愿者组显示出快速增加的曲线,而 pSS 患者组显示出缓慢增加的曲线。患者组的斜率 1st、峰值和刺激后总唾液分泌量均明显低于志愿者组( = 0.005, = 0.003,和 = 0.002,分别)。两组间达峰时间无显著差异( = 0.383)。斜率 1st 可作为诊断 SS 患者的鉴别指标( = 0.015;优势比= 4.234;曲线下面积= 0.726)。

结论

动态磁共振唾液腺造影被证明是一种评估唾液腺功能的有效方法,在诊断和评估 pSS 患者方面具有很大的潜力。

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