二维超声联合弹性成像技术对干燥综合征泪腺病变的诊断价值

The diagnostic value of two-dimensional ultrasound combined with elastography in lacrimal glands in Sjögren’s syndrome

目的探讨二维超声联合剪切波弹性成像技术(SWE)对干燥综合征(SS)泪腺病变的诊断价值。方法选取2018年11月至2019年11月我院风湿免疫科经2002年美欧共识小组(AECG)标准诊断的51例SS患者作为病例组,另随机选取同期正常体检者60例作为对照组,采用超声半定量评分方法对双侧泪腺进行评分。SWE技术获得杨氏模量平均值(Emean)并绘制受试者工作特征(ROC)曲线。结果对照组泪腺回声正常53例(53/60,88.3%),评为0分;病例组47例(47/51,92.1%)的评分≥1分。病例组泪腺超声评分高于对照组(P<0.05)。病例组泪腺Emean明显高于对照组(P<0.05)。病例组内0~3分泪腺Emean依次增高(P<0.05)。病例组Emean值与评分呈线性正相关(r=0.761,P<0.001)。ROC曲线结果显示,SWE技术诊断病例组内0~3分的Emean截断值分别为9.65 kPa、12.20 kPa、13.85 kPa和17.10 kPa。结论二维超声可清楚观察到腺体回声、大小,SWE可定量获得泪腺的杨氏模量值,二维超声联合SWE泪腺检查对SS早期诊断具有重要价值。

Objective To investigate the value of two-dimensional ultrasound combined with shear-wave elastography(SWE)in diagnosing lacrimal gland lesions in Sj?gren’s syndrome(SS).Methods A total of 51 patients with SS who were diagnosed according to the American European Consensus Group(AECG)criteria in 2002 in the Department of Rheumatology of our hospital from November 2018 to November 2019 were selected as the case group,and 60 patients with normal physical examination during the same period were randomly selected as the control group,with scoring done using the ultrasound semi-quantitative scoring method.The mean Young’s modulus(Emean)was obtained by SWE technology,and the receiver operating characteristic curve(ROC)was drawn.Results In the control group,53 cases(53/60,88.3%)had normal echo,with a score of 0,while 47 patients in the case group(47/51,92.1%)scored≥1(P<0.05).The Emean of lacrimal glands in the case group was significantly higher than that in the control group(P<0.05).With the increase of the level in the case group,the Emean of lacrimal glands gradually increased(P<0.05).The Emean of the case group had a positive linear correlation with the score(r=0.761,P<0.001).The ROC curve showed that the cut-off values of 0-3 score of SWE were 9.65 kPa,12.20 kPa,13.85 kPa,and 17.10 kPa.Conclusion Two-dimensional ultrasound can clearly show changes in gland echo and size.SWE can quantitatively obtain Young’s modulus of the lacrimal gland.Two-dimensional ultrasound combined with SWE through lacrimal gland examination is of great value in the early diagnosis of SS.