Gewählte Publikation:
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Krebs
Kardio
Lipid
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Dejaco, C; De Zordo, T; Heber, D; Hartung, W; Lipp, R; Lutfi, A; Magyar, M; Zauner, D; Lackner, A; Duftner, C; Horwath-Winter, J; Graninger, WB; Hermann, J.
Real-time sonoelastography of salivary glands for diagnosis and functional assessment of primary Sjögren's syndrome.
Ultrasound Med Biol. 2014; 40(12):2759-2767
Doi: 10.1016/j.ultrasmedbio.2014.06.023
Web of Science
PubMed
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
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Dejaco Christian
- Co-Autor*innen der Med Uni Graz
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Graninger Winfried
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Heber Daniel
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Hermann Josef
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Horwath-Winter Jutta
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Lackner Angelika
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Lipp Rainer
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Lutfi Andre
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Magyar Marton
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Zauner Dorothea
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- Abstract:
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The purpose of this study was to investigate the value of real-time sonoelastography (RTS) of salivary glands for the diagnosis and assessment of glandular damage in primary Sjögren's syndrome (pSS). After institutional review board approval, 45 pSS patients, 24 sicca patients and 11 healthy controls were investigated prospectively. Questionnaires were completed and Saxon and Schirmer tests and routine blood tests carried out in all patients. All patients underwent B-mode ultrasonography and RTS of parotid and submandibular glands. Abnormal findings were graded from 0 to 48 and from 0 to 16, respectively. Sialoscintigraphy was done according to a routine protocol; scoring ranged from 0 to 12. Statistical analysis comprised receiver operating characteristic curve and multivariate regression analysis. Patients with pSS had higher B-mode (median score = 25 [range: 2-44] vs. 9 [1-20], p < 0.001) and RTS (6.5 [2-13] versus 4 [1-9], p < 0.001) scores than controls with sicca syndrome, yielding areas under the curve of 0.83 and 0.85 (p < 0.05 each), respectively for pSS diagnosis. In cases with an inconclusive B-mode ultrasonography result, RTS (cutoff score: ≥ 6) led to a sensitive (66.7%) and specific (85.7%) classification of patients and sicca controls. In multivariate regression analysis, RTS (regression coefficient = -0.48, p = 0.005), but not B-mode ultrasonography, reflected impaired salivary gland function according to the Saxon test, whereas none of the subjective measures of dryness or discomfort were related to ultrasonography results. B-mode and RTS results were both associated with sialoscintigraphy scores (regression coefficient = 0.66, p < 0.001, and regression coefficient = 0.55, p = 0.001, respectively). Reproducibility of B-mode ultrasonography and RTS was good, with intra-class correlation coefficients of 0.93 (95% confidence interval: 0.57-0.98) and 0.93 (95% confidence interval: 0.79-0.98), respectively. In summary, RTS might be a useful adjunct to B-mode ultrasonography for diagnosis and assessment of salivary gland impairment in primary Sjögren's syndrome.
Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
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Elasticity Imaging Techniques - methods
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Image Interpretation, Computer-Assisted - methods
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Salivary Glands - diagnostic imaging
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Sjogren's syndrome
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Ultrasonography
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Elasticity imaging techniques
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Xerostomia
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Xerophthalmia