唾液腺动态显像定量分析对原发干燥综合征的诊断及评估病变程度的临床研究

Quantitative Analysis of Dynamic Salivary Gland Images on the Diagnosis and Lesion Evaluation of Primary Sjgren Syndrome

目的探讨唾液腺动态显像在原发干燥综合征(pSS)诊断及病变程度评估中的临床应用价值。方法选取2010年4—11月在我科检查的pSS患者44例及28例体检健康者(对照组),对两组受检者进行常规99mTcO4-唾液腺动态显像,获得腮腺及颌下腺的动态显像图像,通过勾画腺体的感兴趣区(ROI),获得腮腺及颌下腺的时间-放射性曲线(TAC)及功能指标:摄取指数(UR)、相对摄取率(S/T)、酸刺激后腺体排泄率(SR)、酸刺激后唾液腺放射性计数由高峰降至最低的时间(Tmin)、酸刺激后平均排泌速率(V)。分析pSS患者与健康者各项功能指标的差异。结果 44例pSS患者中,23例患者的动态显像图像及TAC表现为轻度受损(轻度受损组),21例表现为重度受损(重度受损组)。对照组、轻度受损组、重度受损组的腮腺、颌下腺的UR、S/T、SR、Tmin、V比较,差异均有统计学意义(P<0.01)。其中轻度受损组、重度受损组腮腺、颌下腺的UR、S/T、SR、V均低于对照组,而Tmin均高于对照组,差异有统计学意义(P<0.05);与轻度受损组比较,重度受损组患者腮腺、颌下腺的UR、S/T、SR、V均降低,而Tmin则升高,差异有统计学意义(P<0.05)。结论唾液腺动态显像显示pSS轻度受损者的唾液腺摄取及排泌功能较健康者降低,且重度受损者的唾液腺摄取及排泌功能亦较轻度受损者降低。故唾液腺动态显像对pSS的诊断及病变程度评估具有重要的临床价值。

Objective To evaluate the clinical value of quantitative analysis of dynamic salivary gland images on the diagnosis and lesion evaluation of primary Sjogren＇s syndrome （pSS） . Methods 44 pSS patients admitted to our department from April to November of 2010 and 28 healthy people （ control group） were examined with 99mTcO4 - dynamic salivary gland ima- ges to get the dynamic imaging picture of external salivary gland and submaxillary glands. The region of interest （ROI） was drawnto obtain the time -activity curve （TAC） and some function parameter of glands, such as uptake ratio （UR）, relative uptake ratio （S/T）, gland secretion rate post -stimulus by acid （SR）, the time of gland radiocounting post - stimulus by acid from the peak to reach the minimal value （Tmin） and average secretion velocity post- stimulus by acid （V） . The difference of each function parameter in pSS patients and the health people was analyzed. Results Among the 44 pSS patients, 23 showed slight damage （slight damage group） in the dynamic imaging pictures and TAC, 21 showed severe damage （severe damage group）. The UR, S/T, SR, Tmin and V of salivary gland and submaxillary glands between control group, slight damage group and se- vere damage group showed statistically significant differences （P 〈 0. 01 ） . The UR, S/T, SR and V in the slight damage group and severe damage group were significantly lower than the control group, while the Tmin was significantly higher than the control group （P 〈0. 05） . Compared with the slight damage group, the UR, S/T, SR and V in the severe damage group were signifi- cantly decreased, while the Tmin was significantly increased （ P 〈 0. 05 ） . Conclusion Dynamic salivary gland images show that the absorbing and secreting function of salivary gland in pSS slight damaged patients are decreased, the decreasing is even worse in severe damaged patients. Dynamic salivary gland images are of great importance for the diagnosis and lesion evaluation of pSS in clinic.