Yoshiura K, Yuasa K, Tabata O, Araki K, Yonetsu K, Nakayama E, Kanda S, Shinohara M, Higuchi Y
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kyushu University, Fukuoka, Japan.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Mar;83(3):400-7. doi: 10.1016/s1079-2104(97)90249-3.
The purpose of this study was to evaluate quantitatively observer performance with ultrasonography and sialography in the diagnosis of parotid gland involvement of Sjögren's syndrome.
Sixty-four parotid gland sialograms and 65 ultrasonograms were prepared for observer performance experiments. They included both modalities in 24 Sjögren's syndrome and 19 nonspecific parotitis cases, 21 normal parotid gland sialograms, and 22 normal ultrasonograms in healthy volunteers. The images were randomly sequenced and presented to five observers who were asked to describe several findings and finally to determine the imaging diagnosis by ranking the abnormal features and the diagnosis on a five-point-rating scale. Observer performance was evaluated on the basis of the reliability of findings interpreted and the diagnostic accuracy of each modality from observers' rating scores.
The diagnostic accuracy of sialography was very high, nearly perfect. The diagnostic accuracy of ultrasonography was lower than that of sialography, resulting from the lower incidence of characteristic findings in the disease groups and lower sensitivity on ultrasonography. In the differentiation of Sjögren's syndrome from the normal, however, the diagnostic accuracy of ultrasonography increased to 80% for all cases, and up to nearly 90% in the advanced sialographic stages.
Ultrasonography is useful for the diagnosis of Sjögren's syndrome in the advanced stages. Taking the noninvasiveness of this technique into account we recommend first applying ultrasonography to the diagnosis of Sjögren's syndrome and performing sialography when no positive findings are detected on ultrasonography.
本研究旨在定量评估超声检查和涎腺造影在诊断干燥综合征腮腺受累情况时观察者的表现。
准备了64份腮腺涎腺造影片和65份超声图像用于观察者表现实验。其中包括24例干燥综合征和19例非特异性腮腺炎病例的两种检查方式的图像，21份正常腮腺涎腺造影片，以及22份健康志愿者的正常超声图像。图像随机排序后呈现给5名观察者，要求他们描述几项发现，并最终通过对异常特征和诊断进行五点评分来确定影像学诊断。根据观察者评分结果中解释发现的可靠性以及每种检查方式的诊断准确性来评估观察者的表现。
涎腺造影的诊断准确性非常高，近乎完美。超声检查的诊断准确性低于涎腺造影，这是由于疾病组中特征性发现的发生率较低以及超声检查的敏感性较低。然而，在区分干燥综合征与正常情况时，超声检查对所有病例的诊断准确性提高到80%，在涎腺造影晚期高达近90%。
超声检查对晚期干燥综合征的诊断有用。考虑到该技术的非侵入性，我们建议首先应用超声检查诊断干燥综合征，当超声检查未发现阳性结果时再进行涎腺造影。
