Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
Department of Rheumatology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
Sci Rep. 2019 Jul 3;9(1):9614. doi: 10.1038/s41598-019-46054-6.
At present, no gold standard for diagnosing Sjögren's syndrome (SS) is available in clinical practice. The 2002 American-European Consensus Group classification criteria are used to diagnose SS. Clinically, it is challenging to distinguish patients with SS from suspected patients undergoing different therapies. A total of 52 patients with SS and 24 patients suspected of having the disease prospectively underwent 3.0-T magnetic resonance (MR) scanning, including diffusion-weighted imaging (b = 0 and 1000 s/mm). The whole-volume apparent diffusion coefficient (ADC) histogram analysis generated ADC, skewness, kurtosis, and entropy values from bilateral parotid glands. Continuous variables were compared using an independent two-sample t test, and categorical variable compared using the Fisher's test between the two groups. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of the indexes. Fisher's tests demonstrated that some clinical indexes and MR morphology grades differed significantly between patients with SS and patients suspected of having the disease (all P ≤ 0.001). The parotid entropy value of patients with SS was significantly higher than that of patients suspected of having the disease (P < 0.001). Among MR parameters, entropy combined with kurtosis performed the best in differentiating patients with SS from those suspected of having SS (area under the ROC curve = 0.955). A whole-volume ADC histogram analysis might provide a series of parameters that reflect tissue characteristics.
目前，临床上尚无诊断干燥综合征（SS）的金标准。采用 2002 年美国-欧洲共识组分类标准诊断 SS。临床上，区分 SS 患者和接受不同治疗的疑似患者具有挑战性。共有 52 例 SS 患者和 24 例疑似患者前瞻性接受了 3.0-T 磁共振（MR）扫描，包括弥散加权成像（b=0 和 1000 s/mm）。全容积表观扩散系数（ADC）直方图分析从双侧腮腺生成 ADC、偏度、峰度和熵值。使用独立样本 t 检验比较连续变量，使用 Fisher 检验比较两组间的分类变量。使用受试者工作特征（ROC）分析评估指标的诊断性能。Fisher 检验表明，SS 患者和疑似患者之间的一些临床指标和 MR 形态学分级差异有统计学意义（均 P≤0.001）。SS 患者的腮腺熵值明显高于疑似患者（P<0.001）。在 MR 参数中，熵结合峰度在区分 SS 患者和疑似 SS 患者方面表现最佳（ROC 曲线下面积=0.955）。全容积 ADC 直方图分析可能提供一系列反映组织特征的参数。
