Is Elastography a New Tool to Differentiate Sjögren Syndrome to Sicca Syndrome?: Results of the Elsa (elastography of salivary glands) Study

Sandrine Jousse-Joulin¹, luc Bressollette², thibault depinoy³, guillermo carvajal Alegria³, Divi Cornec⁴, Thierry Marhadour⁵, Dewi Guellec⁶, Valérie Devauchelle-Pensec⁷ and Alain Saraux⁸, ¹Rheumatology, CHu La cavle Blanche, Brest, France, ²Doppler unit, Cavale Blanche hospital, brest, France, ³rheumatology department, cavale blanche hospital, brest, France, ⁴CHU Brest, Brest, France, ⁵Rheumatology, CHU La Cavale Blanche, Brest, France, ⁶Rheumatology, CHU Brest, Brest, France, ⁷Rheumatology, Brest university medical school, EA 2216, Lab Ex, INSERM, IGO,UBO and CHU de la Cavale Blanche,, Brest, France, ⁸Rheumatology, Brest University Medical School Hospital, Brest, France

Meeting: ACR/ARHP Annual Meeting 2017

Date of first publication: September 18, 2017

Keywords: salivary gland and ultrasonography, SICCA, Sjogren's syndrome

Session Information

Date: Sunday, November 5, 2017

Title: Sjögren's Syndrome Poster I: Translational Research

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

Ultrasonography (US) has been developed in salivary glands (SG) and particularly in primary Sjögren syndrome (pSS) for 10 years. However, the training curve is long and the reliability is not completely achieved (1). A new tool procedure has been developed to study the elasticity of the tissue parenchyma using elastography and could be implemented in the evaluation of SGUS pSS patients. The objective was to evaluate SGUS using grey scale (GS) and the elasticity salivary glands parenchyma using elastography to differentiate pSS from sicca syndrome (SS) patients in a longitudinal consultation of sicca syndrome in Doppler Unit of Brest (France).

Methods: 63 patients complaining of sicca syndrome were enrolled in the ELSA study. At inclusion, all patients underwent a standardized workup including a clinical evaluation, laboratory tests, SG histology, SGUS and elastography. Immunological testing included: anti-nuclear antibodies, anti-SSA (recognizing both Ro 52 and 60 kDa), anti SSB, native anti-DNA, ANCA, rheumatoid factors and anti-CCP. A Toshiba Applio machine was used to evaluate in GS SGUS parenchyma and elastography -elastometry. The 6 main SG were examined in US according to previous scoring (2) elastography (with color map) and elastometry (in cm/sec) and :left parotid gland (USLPG), left submandibular gland (USLSMG), left sublingual gland (USLSLG), right parotid gland, (USRPG) right submandibular gland (USRSMG), right sublingual gland (USRSLG).

Results: 15 patients fulfilled the AECG criteria. The clinical characteristics of the patients in terms of ocular dryness and shirmer test were not significant between pSS and Sicca patients. There was a significant difference (p= 0.04) concerning oral dryness (p=0.04), immunological datas: Antinuclear antibodies and anti SSA and minor salivary glands biopsy (p=0.007). We found significant differences between the 2 groups in GS for the USLPG (p=0.021) and USLSMG (p=0.05). Evaluation of sublingual glands using US in grey scale and elastometry of the 6 SG showed no significant differences between the two groups.

Conclusion: Grey scale SGUS seems to be more sensitive to differentiate pSS to Sicca patients compared to elastometry. US of sublingual glands showed no involvement in the echostructural damage in pSS patients and suggest not examining these glands in the USpSS evaluation. Elastometry has been described to be a new tool and might be added as a new imaging technique to ultrasonography in pSS patients (3). However, ELSA study results showed no differences between pSS and Sicca patients. We need to follow the evolution of the Sicca population with US in GS and elastometry to detect potential echostrural parenchymal damage which might not yet be present at inclusion.

Disclosure: S. Jousse-Joulin, None; L. Bressollette, None; T. depinoy, None; G. carvajal Alegria, None; D. Cornec, None; T. Marhadour, None; D. Guellec, None; V. Devauchelle-Pensec, None; A. Saraux, None.

To cite this abstract in AMA style:

Jousse-Joulin S, Bressollette L, depinoy T, carvajal Alegria G, Cornec D, Marhadour T, Guellec D, Devauchelle-Pensec V, Saraux A. Is Elastography a New Tool to Differentiate Sjögren Syndrome to Sicca Syndrome?: Results of the Elsa (elastography of salivary glands) Study [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/is-elastography-a-new-tool-to-differentiate-sjogren-syndrome-to-sicca-syndrome-results-of-the-elsa-elastography-of-salivary-glands-study/. Accessed .

ACR Meeting Abstracts - https://acrabstracts.org/abstract/is-elastography-a-new-tool-to-differentiate-sjogren-syndrome-to-sicca-syndrome-results-of-the-elsa-elastography-of-salivary-glands-study/