Oruk Yunus Emre, Çildağ Mehmet Burak, Karaman Can Zafer, Çildağ Songül
Department of Diagnostic Radiology, Muğla Menteșe State Hospital, Muğla, Turkey.
Department of Diagnostic and Interventional Radiology, Adnan Menderes University, Aydin, Turkey.
Ultrasonography. 2021 Oct;40(4):584-593. doi: 10.14366/usg.21014. Epub 2021 Mar 23.
This study investigated the effectiveness of major salivary gland ultrasonography (MSGUS) using a new grading system and shear wave elastography (SWE) in evaluating the major salivary glands of patients with Sjögren syndrome (SjS).
This prospectively-designed cross-sectional study included 49 SjS patients and 49 healthy controls. Major salivary glands were examined with gray-scale ultrasonography and SWE. A new grading system for salivary glands was developed using MSGUS findings. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MSGUS and shear wave velocity (SWV) values were investigated. The MSGUS grading system and SWV values were evaluated together by logistic regression analysis. A cutoff value of SWE for salivary glands was determined.
The sensitivity, specificity, PPV, and NPV of MSGUS were 69.4%, 73.5%, 72.3%, and 70.6% for the submandibular gland and 69.4%, 65.3%, 66.7%, and 68.1% for the parotid gland, respectively. The mean SWV values of the parotid and submandibular glands were significantly higher in SjS patients than in controls (P<0.05). The sensitivity, specificity, PPV, and NPV for the submandibular gland (cutoff, 1.95 m/s) and the parotid gland (cutoff, 2.39 m/s) were 69.4%, 52%, 59.1%, and 63% and 82.7%, 83.7%, 83.5%, and 82.8%, respectively. Adding SWE to the parotid gland grading system increased the sensitivity and specificity (sensitivity, 82.7%; specificity, 83.7%).
Evaluating the salivary glands using MSGUS with a new grading system and SWE may contribute to the diagnosis of SjS. The combination of MSGUS and SWE may be a promising tool for diagnosing SjS.
本研究使用一种新的分级系统和剪切波弹性成像（SWE）来探究大唾液腺超声检查（MSGUS）在评估干燥综合征（SjS）患者大唾液腺方面的有效性。
这项前瞻性设计的横断面研究纳入了49例SjS患者和49例健康对照者。使用灰阶超声和SWE对大唾液腺进行检查。根据MSGUS检查结果制定了一种新的唾液腺分级系统。研究了MSGUS和剪切波速度（SWV）值的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。通过逻辑回归分析对MSGUS分级系统和SWV值进行综合评估。确定了唾液腺SWE的截断值。
MSGUS对下颌下腺的敏感性、特异性、PPV和NPV分别为69.4%、73.5%、72.3%和70.6%，对腮腺的敏感性、特异性、PPV和NPV分别为69.4%、65.3%、66.7%和68.1%。SjS患者腮腺和下颌下腺的平均SWV值显著高于对照组（P<0.05）。下颌下腺（截断值为1.95 m/s）和腮腺（截断值为2.39 m/s）的敏感性、特异性、PPV和NPV分别为69.4%、52%、59.1%和63%以及82.7%、83.7%、83.5%和82.8%。在腮腺分级系统中加入SWE可提高敏感性和特异性（敏感性为82.7%；特异性为83.7%）。
使用新分级系统的MSGUS和SWE评估唾液腺可能有助于SjS的诊断。MSGUS和SWE的联合应用可能是诊断SjS的一种有前景的工具。
