剪切波弹性成像对原发性干燥综合征的诊断价值

Diagnostic Value of Shear Wave Elastography in Primary Sjogren′s Syndrome

目的:探讨剪切波弹性成像对原发性干燥综合征(pSS)的诊断价值。方法:收集50例初次诊断为pSS病人,根据唇腺病理结果分为阴性组和阳性组,另择同期94名健康志愿者为对照组,测量并对比3组研究对象的腮腺剪切波弹性成像杨氏模量值,绘制受试者工作特征曲线(ROC),计算pSS病人腮腺杨氏模量的诊断界值和诊断效能。结果:50例病人中唇腺病理阴性17例,唇腺病理阳性33例。唇腺病理阴性组与对照组比较腮腺杨氏模量Emin、Emax和SD差异无统计学意义(P>0.05),但Emean值高于对照组(P<0.05)。唇腺病理阳性组上述4个指标均高于对照组和唇腺病理阴性组(P<0.01)。以Emean=18.38 kPa作为诊断pSS的界值,AUC为0.874(95%CI:0.799~0.950),灵敏度为74%,特异度为99%,约登指数为0.729;以Emax=20.55 kPa作为诊断界值,AUC为0.863(95%CI:0.785~0.941),灵敏度为80%,特异度为88%,约登指数为0.683。结论:剪切波弹性成像诊断pSS的灵敏度及特异度均较高,有助于诊断pSS。

Objective:To investigate the diagnostic value of shear wave elastography in primary Sjogren′s syndrome(pSS).Methods:50 patients with an initial diagnosis of pSS were collected and divided into a negative group and a positive group based on the pathological results of the labial gland.Another 94 healthy volunteers in the same period were selected as the control group.The Young′s modulus values of the parotid gland shear wave elastic imaging were measured and compared among three study subjects.The receiver operating characteristic curve(ROC)was plotted,and the diagnostic threshold and diagnostic efficacy of the Young′s modulus of the parotid gland in pSS patients were calculated.Results:Among the 50 patients,17 had negative lip gland pathology and 33 had positive lip gland pathology.There was no statistically significant difference in Young′s modulus,Emin,Emax,and SD between the lip gland pathology negative group and the control group(P>0.05),but the Emean value was higher than the control group(P<0.05).The above four indicators in the lip gland pathology positive group were higher than those in the control group and lip gland pathology negative group(P<0.01).Using Emean=18.38 kPa as the diagnostic threshold for pSS,the AUC was 0.874(95%CI:0.799-0.950),the sensitivity was 74%,the specificity was 99%,and the Youden′s index was 0.729;using Emax=20.55 kPa as the diagnostic threshold,AUC was 0.863(95%CI:0.785-0.941),sensitivity was 80%,specificity was 88%,and the Youden′s index was 0.683.Conclusions:The sensitivity of shear wave elastography in the diagnosis of pSS is higher than that of labial gland pathology,and it is helpful for the diagnosis of pSS.