唾液腺超声评分联合核素显像对干燥综合征具有较高的诊断价值

Diagnostic value of salivary gland ultrasound score combined with radionuclide imaging in Sjogren’s syndrome

目的 分析唾液腺超声评分联合核素显像参数对干燥综合征(SS)的诊断价值。方法 选取2018年1月~2021年12月本院收治的105例SS患者作为研究组,另选取同期105例有口干、眼干症状的非SS患者作为对照组。采用唾液腺超声检查和核素显像,观察两组患者超声图像、核素显像及唾液腺功能。采用ROC曲线分析超声评分联合核素显像对SS患者的诊断价值。结果超声声像图显示,SS患者可见腮腺呈弥漫性病变,腮腺或颌下腺有1个或多个低回声结节;核素显像显示,SS患者可见双侧腮腺和颌下腺摄取功能明显降低,唾液腺对^(99)Tc^(m)O_(4)-摄取减少,口腔^(99)Tc^(m)O_(4)-浓聚更少,口服维生素C后未见明显浓聚,双侧腮腺和颌下腺呈持续上升。研究组颌下腺评分、腮腺评分及唾液腺超声评分均高于对照组(P<0.05),根据临床诊断为准制作ROC曲线,其中唾液腺超声总评分的诊断价值最高,其与颌下腺评分和腮腺评分的差异有统计学意义(P<0.05)。研究组颌下腺、腮腺摄取指数和腺体排泄率水平均低于对照组(P<0.05),根据临床诊断为准制作ROC曲线,其中唾液腺超声评分联合核素显像的诊断价值最高,其与单独诊断比较,差异有统计学意义(P<0.05)。结论 唾液腺超声评分联合核素显像对SS患者具有较高的诊断价值。

Objective To explore the diagnostic value of salivary gland ultrasound scoring combined with nuclide imaging parameters in sjogren’s syndrome(SS). Methods A total of 105 SS patients admitted to our hospital from January 2018 to December 2021 were selected as the study group, and 105 non-SS patients with dry mouth and dry eye were selected as the control group. Salivary gland ultrasonography and radionuclide imaging were used to observe the ultrasonic image,radionuclide imaging and salivary gland function in two groups. ROC curve was used to analyze the diagnostic value of ultrasonic scoring combined with radionuclide imaging in SS patients. Results Ultrasound imaging showed diffuse lesions in parotid gland and one or more hypoechoic nodules in parotid gland or submandibular gland. Radionuclide imaging showed that the uptake function of bilateral parotid gland and submandibular gland was significantly reduced in SS patients, the uptake of^(99)Tc^(m)O_(4)-in salivary gland was reduced, and the concentration of^(99)Tc^(m)O_(4)-in oral cavity was less. No obvious concentration was observed after oral vitamin C. The bilateral parotid gland and submandibular gland were continuously increased. The submandibular gland score, parotid gland score and salivary gland ultrasound score in the study group were significantly higher than those in the control group(P<0.05). ROC curve was made based on clinical diagnosis, among which the total salivary gland ultrasound score had the highest diagnostic value and had significant differences with the submandibular gland score and parotid gland score(P<0.05). The levels of UR and SR in the submandibular gland and parotid gland in the study group were significantly lower than those in the control group(P<0.05). ROC curve was made based on clinical diagnosis, in which the ultrasonic score of salivary gland combined with radionuclide imaging had the highest diagnostic value, and there were significant differences compared with the diagnosis alone(P<0.05). Conclusion Salivary gland ultrasound scoring combined with radionuclide imaging has high diagnostic value in SS patients.