Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose
Primary Sjogren’s syndrome (pSS) is a chronic systemic autoimmune disease characterized by clinically xerophthalmia and xerostomia. Those standard tests of salivary glands involvement has some deficiency. To date, a precise and feasible evaluation method for primary Sjogren’s syndrome (pSS) remains to be established. Ultrasonography (US) is a promising technique, as it is convenient, economic, and non-invasive. A consensus has not been reached regarding the evaluation of typical SGUS changes for pSS, and at present, two main scoring systems exist (range 0-16, 0-48, respectively). To date, it’s unknown which one is more practical and useful. On the other hand, sonoelastography (SE) is a rapidly developping technique by which the tissue elasticity can be measured. SE has been investigated in the differential diagnosis of focal nodule of breast, thyroid, prostate and salivary gland and liver fibrosis, as an accurate and reproducible method. However, the application of sonoelastography to salivary diffuse pathologic lesions never reported. We aimed to assess and compare the usefulness of two existing SGUS scoring systems for primary pSS and explore the performance of SE in the diagnosis of pSS.
Methods
US and SE examination of major salivary glands was conducted for 105 pSS patients and 41 non-SS patients with 10 Sicca syndrome, 5 hypothyroidism, 19 rheumatoid arthritis, 7 systemic lupus erythematosus and 16 healthy subjects. The ultrasonographic features were graded using two different scoring systems (0–16, 0–48, respectively) obtained from the grades of bilateral parotid and submandibular glands. On the other hand, elastographic images was determined with a qualitative 4-point scoring method (range 0-16).Receiver operating characteristic (ROC) curves were used to describe and compare the diagnostic accuracy of the two US echostructure scoring systems for pSS, simutaneously, to evaluate the performance of qulalitative elasticity scoring by sonoelastography.
Results
1) SGUS scores for the pSS group were significantly higher than those for the non-pSS group (P< 0.001). The maximal combination of sensitivity and speciality was 80% and 93% at an optimal US cut-off value of 7 in the 0–16 system, and was 88.6% and 84.2% at a best cut-off of 15 in the 0–48 system. For the 0-48 system, the sum of the scores of all four glands provided the best diagnostic accuracy. 2) Scores of elasticity for pSS group were significantly higher than those for non-pSS group by different calculated qulalitative methods (p<0.001). Referring to the ROC curves, the sum of the scores of all four glands provided the largest AUC-ROC (0.916, 95% CI 0.87 - 0.962). The maximal sensitivity and specificity were 81% and 87% at an optimal cut-off value of 9 for the sum of the scores of all four glands.
Conclusion
SGUS showed good sensitivity and specificity for noninvasive assessment of salivary glands for pSS diagnosis. Moreover, compared to the 0–16 system, the 0–48 system had a slightly higher sensitivity. The qualitative assessment of salivary elasticity with SE was of diagnostic value to pSS.
Disclosure:
X. Zhang,
None;
J. He,
None;
Z. Li,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/ultrasonographic-evaluation-of-major-salivary-glands-in-primary-sjogrens-syndrome-comparison-of-two-scoring-systems-and-diagnostic-value-of-sonoelastography/