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Salivary gland ultrasound may enable early detection of Sjögren’s syndrome
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It may be possible to detect the early development of Sjögren’s syndrome distinguished from non-Sjögren’s syndrome sicca symptoms through the use of salivary gland ultrasound, according to recently published data.
Researchers conducted a single-center, cross-sectional study of 50 patients with Sjögren’s syndrome (SS) and 57 patients with non-SS sicca symptoms between January 2011 and March 2013 at the University of Pisa tertiary care referral center. Control patients did not fulfill American-European Consensus Criteria (AECG), and patients were excluded in the presence of viral or bacterial infections or other rheumatic diseases. Mean age of patients with primary SS was 47 years compared with 53 years in the idiopathic sicca syndrome group, with no other apparent differences between groups.
Patient information, symptom history and demographic information were collected and laboratory tests were performed. Ultrasound of the salivary glands was performed by two experienced radiologists blinded to patients’ clinical data. The parotid and submandibular glands were scanned with patients in a supine position, with the neck hyperextended and head slightly turned away from the scanning side. Transverses and longitudinal planes scans were performed in the parotid gland and across a longitudinal plane of the submandibular gland with a Logiq 9 (General Electric Medical Systems) equipped with a linear probe at 10 MHz. Gland size and parenchymal echogenicity and inhomogeneity were recorded, and changes in the echostructure of the glands were assessed using a scoring system proposed by de Vita, et al.
Among the patients with confirmed SS, echogenicity of the parotid glands was increased in 22 of the 50 patients vs. two of 57 patients in the non-SS sicca syndrome group. Additionally, the echogenicity of the submandibular glands in 34 of the patients with SS compared with four of the patients in the non-SS group. Abnormal ultrasound results and overall higher ultrasound scores were observed in about 66% of patients with SS, but abnormal results were seen in less than 10% of patients with non-SS sicca syndrome, according to the researchers.
The ultrasound score was inversely correlated with the unstimulated salivary gland flow rate and biopsy results of the major salivary gland. Ultrasound scores showed similar specificity and lower sensitivity compared with biopsy of the major salivary gland, with moderate agreement observed between the two procedures, according to the researchers. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
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