声辐射力脉冲成像对干燥综合征的诊断价值

Acoustic Radiation Force Impulse Imaging in Diagnosing Sj?gren's Syndrome

目的探讨声辐射力脉冲(ARFI)成像在干燥综合征(SS)诊断中的应用价值。资料与方法收集2015年9月-2016年4月南昌大学第一附属医院风湿免疫科门诊或住院的口干、眼干患者64例。依据2002年SS欧美联盟分类(诊断)标准将患者分为SS组(n=38)及非SS组(n=26)。对双侧腮腺及颌下腺进行ARFI成像检查,获得双侧腮腺及颌下腺的剪切波速度(SWV)。比较同一组内腮腺、颌下腺左侧与右侧之间以及不同组间同侧腮腺、颌下腺SWV的差异。结果 1两组组内不同侧腮腺、颌下腺间SWV值差异均无统计学意义(P>0.05);组间双侧腮腺、颌下腺SWV值差异均有统计学意义(P<0.05)。2腮腺ARFI成像诊断SS的最佳截断值1.99 m/s,敏感度、特异度、Youden指数及受试者工作特性(ROC)曲线下面积(AUC)分别为86.3%、80.8%、0.671及0.879。3颌下腺ARFI成像诊断SS的最佳截断值2.13 m/s,敏感度、特异度、Youden指数及AUC分别为79.5%、80.8%、0.603及0.878。结论 ARFI成像可以提供腮腺及颌下腺SWV值,定量反映SS的腺体弹性,在SS诊断中具有重要价值。

Purpose To evaluate the value of acoustic radiation force impulse （ARFI） imaging in the diagnosis of Sjogren＇s syndrome （SS）. Materials and Methods Sixty-four cases of outpatients or inpatients with xerophthalmia or xerostomia in the Department of Rheumatology and Immunology of the First Affiliated Hospital of Nanchang University from September 2015 to April 2016 were collected. According to American-European Consensus Group criteria of 2002, the subjects were divided into SS group （n=38） and non- SS group （n=26）. The bilateral parotid gland and submandibular gland were examined by ARFI imaging, and the shear wave velocity （SWV） value was obtained. The differences in SWV values between the left and right sides of the parotid gland or submandi-bular gland and between the SS group and the non-SS group were analyzed. Results ① The SWV values between two sides of parotid glands or submandibular gland in SS group or non-SS group showed no significant differences （P〉0.05）. The difference of SWV between the two groups was statistically significant （P〈0.05）. ② According to the ARFI imaging of parotid gland, the optimal cutoff value, sensitivity, specificity, Youden index and ROC area under the curve were 1.99 m/s, 86.3%, 80.8%, 0.671 and 0.879, respectively. ③ According to the ARFI imaging of submandibular glands, the optimal cutoff value, sensitivity, specificity, Youden index and ROC area under the curve were 2.13 m/s, 79.5%, 80.8%, 0.603 and 0.878, respectively. Conclusion The ARFI imaging can provide the SWV value of salivary glands to quantify the elasticity of salivary glands in SS, which has great value in the diagnosis of SS.