唾液腺显像诊断干燥综合征

Salivary gland scintigraphy in diagnosis of Sjgren's syndrome

目的探讨唾液腺显像诊断干燥综合征的价值。方法回顾性分析44例临床怀疑干燥综合征(SS)患者的唾液腺显像资料,在双侧腮腺、颌下腺勾画ROI获得时间-放射性曲线(TAC),对曲线进行定量分析获得唾液腺摄取指数(UI)和排泌分数(EF),分析UI和EF与唾液腺显像定性分级诊断结果的相关性,并比较其诊断SS的效能。结果与非SS患者相比较,SS患者唾液腺UI和EF均明显减低(P均<0.05)。定性诊断评价唾液腺功能受损程度分为0~3级,双侧颌下腺、腮腺UI与定性诊断分级呈负相关(P均<0.001);除右侧颌下腺EF与唾液腺显像定性分级呈负相关外(r=-0.312,P=0.039),其余腺体EF与定性诊断分级无相关性(P均>0.05)。UI的综合诊断效能均高于定性诊断,但是其ROC曲线下面积与定性诊断比较差异无统计学意义(P均>0.05)。结论唾液腺显像定量分析可准确评价唾液腺功能,对诊断SS具有重要价值。

Objective To assess the value of salivary gland scintigraphy in diagnosis of Sjgren＇s syndrome（SS）.Methods A total of 44 patients with clinically suspicious SS were included.The data of salivary gland scintigraphy were retrospectively analyzed and the time-radioactivity curve（TAC）was obtained by outlining ROI in bilateral parotid glands and submaxillary glands.Uptake index（UI）and excretion fraction（EF）were defined.Both UI and EF were compared with the visual assessment and final diagnosis respectively.Results UI and EF of bilateral parotid glands and submaxillary glands in SS patients were significantly lower than those in non-SS patients（all P〈0.05）.The impaired salivary gland function was classified as 0—3 grades by visual assessment.The UI of bilateral parotid glands and submaxillary glands were negatively correlated with the qualitative classification.While there were no significant correlations between EF and qualitative classification（all P〉0.05）,except for that of right submaxillary gland（r=-0.312,P=0.039）.The comprehensive diagnostic efficacy of UI on SS patients was higher than those of visual assessment,but their area under curves of ROC were not significantly different（all P〉0.05）.Conclusion UI and EF can effectively evaluate salivary gland function and serve as objective tools to distinguish patients with SS.