原发性干燥综合征腮腺磁共振分级与超声评分对比研究

目的根据"2016年EULAR/ACR诊断标准",探讨MRI与US对pSS的诊断效能及两种检查方法分级诊断的一致性.方法选取2018年1月至2019年12月在本院风湿科收治的pSS患者76例作为观察组,另51例非pSS患者作为对照组.所有患者均进行了腮腺MRI和US成像,并进行MRI及US的分级诊断,评价两者诊断效能并将腮腺MRI分级与US评分一致性进行对比研究.结果腮腺MRI诊断pSS的准确度90.6%,敏感度98.7%,特异度78.4%;US诊断pSS的准确度88.2%,敏感度97.4%,特异度74.5%,ROC曲线显示MRI和US检查方法在pSS诊断效能方面的差异无统计学意义.MRI与US在pSS组分级诊断中,二者分级相同的为56例,Kappa值为0.627,同时,对pSS分级行Spearman等级相关系数分析,关联系数r为0.853,P<0.01.结论MRI和US与临床诊断具有较高的一致性,腮腺MRI分级与US评分具有较好的一致性,腺体分级可以提示病变受累程度,为临床治疗及随访提供依据.MRI与US对pSS的诊断效能均较高,两者均可以作为临床诊断pSS的重要手段.

Objective According to the diagnostic criteria of primary Sjogren's syndrome(psS)issued by the European League Against Rheumatism/American College of Rheumatology(EULAR/ACR)in 2016,to explore the diagnostic efficacy of MRI and US score in the diagnosis of pSS and the consistency of the two methods.Methods From January 2018 to December 2019,127 patients with suspected pSS were admitted to the rheumatology department of our hospital.Among them,76 patients with pSS were finally diagnosed,and 51 patients without pSS were selected as the control group.All patients underwent MRI and US examination for parotid gland.MRI and Us result were graded and evaluate their diagnostic efficacy.Results The accuracy of MRI in diagnosing pSS was 90.6%,the sensitivity was 98.7%,and the specificity was 78.4%.The accuracy of US in diagnosing pSS was 88.2%,the sensitivity was 97.4%,and the specificity was 74.5%.The ROC curve showed that there was no significant difference in the diagnostic value of the two methods.In the pSS group,there were 56 cases with the same diagnosis between MRI and US classification.The kappa value was 0.627,and the correlation coefficient r was 0.853(P<0.01).Conclusion MRI and US have high consistency with clinical diagnosis.MRI and US grading of parotid gland have good consistency.Gland grading can indicate the degree of involvement of lesions,and provide basis for clinical treatment and follow-up.Both MRI and US have high diagnostic eficiency for pSS,and can be used as important means for clinical diagnosis of pSS.