剪切波弹性成像与涎腺超声评分法诊断干燥综合征涎腺病变的临床价值

The clinical value of shear wave elastography and salivary gland ultrasound scoring in salivary gland lesions of Sjögren′s syndrome

目的探讨剪切波弹性成像(shear wave elastography,SWE)和涎腺超声评分法诊断干燥综合征(Sjögren′s syndrome,SS)涎腺病变的临床价值,并比较两者的诊断效能。方法收集2019年6月至2020年11月南京医科大学附属常州市第二人民医院风湿科疑诊SS患者58例,依据2002年欧美专家共识分类标准将其分为SS组(47例)、非SS组(11例),并根据病程将SS组分为≤5年组(29例)和>5年组(18例)。同期选取健康成人40例为对照组。分析0~16评分系统及SWE对SS涎腺病变的诊断价值。结果SS组与非SS组及对照组腮腺、颌下腺杨氏模量值差异有统计学意义(均P<0.05);SS组超声评分明显高于非SS组、对照组(均P<0.05);不同病程间SS患者涎腺评分及杨氏模量值的差异无统计学意义(均P>0.05)。腮腺、颌下腺杨氏模量值和超声评分法诊断SS涎腺病变的ROC曲线下面积(AUC)分别为0.801、0.829和0.676,前两者AUC值高于超声评分法(均P<0.05)。结论SWE和超声评分法对SS涎腺病变具有一定的诊断价值,可从不同角度为临床诊断提供重要参考信息;SWE对SS涎腺病变的诊断效能较优于涎腺超声评分法。

Objective To evaluate the value of shear wave elastography(SWE)and salivary gland ultrasound scoring(SGUS)system in the diagnosis of salivary glands lesions in patients with Sjögren′s syndrome(SS)and to compare the diagnostic efficiency of the two methods.Methods From June 2019 to November 2020,Fifty-eight patients with suspected SS were selected from the Affiliated Changzhou No.2 People′s Hospital of Nanjing Medical University.According to the 2002 American-European Consensus Group classification standard,the enrolled patients were divided into two groups:SS group(47 cases)and non-SS group(11 cases).According to symptom duration,SS group was divided into the≤5 years group(29 cases)and the>5 years group(18 cases).Meanwhile,40 healthy volunteers were enrolled in this study as normal control group.The diagnostic value of salivary gland ultrasound scoring system and Young′s modulus in SS were analyzed.Results The differences in Young′s modulus of parotid gland and submandibular gland between SS group and non-SS group(or control group)were statistically significant(all P<0.05).The ultrasound score of SS group was significantly higher than that of non-SS group and control group(all P<0.05).SGUS and Young′s modulus were not significantly different between different course groups(all P>0.05).The areas under ROC curve of the mean Young′s value in parotid and submandibular gland and the SGUS were 0.801,0.829 and 0.676,respectively.The comparison of the area under the curve between the Young′s modulus of the parotid and submandibular glands and the ultrasound score was statistically significant(all P<0.05).Conclusions SWE and Ultrasonography scoring system have certain value in the diagnosis of salivary gland lesions in SS,and can provide important reference information for clinical diagnosis from different perspectives.The diagnostic efficiency of SWE for salivary glands lesions in patients with SS is better than that of SGUS scoring system.