Value of an ultrasonographic scoring system in diagnosis of Sjögren's syndrome

Shiwen Li; Jiao Shi; Xing Hua; Yanli Guo; Jingyi Li; Qinghua Zou

doi:10.16016/j.1000-5404.201701033

您当前的位置：

首页 >

文章列表页 >

Value of an ultrasonographic scoring system in diagnosis of Sjögren's syndrome

更新时间：2026-02-09

- Value of an ultrasonographic scoring system in diagnosis of Sjögren's syndrome
- Journal of Third Military Medical University Vol. 39, Issue 10, Pages: 996-1000(2017)
- 作者机构：
  
  1.400060 重庆，重庆市南岸区人民医院超声科
  2.400038 重庆，第三军医大学西南医院超声科
  3.400038 重庆，第三军医大学西南医院中西医结合风湿免疫科
- 作者简介：
- 基金信息：
  
  the General Program of National Natural Science Foundation of China(81471677)
- DOI：10.16016/j.1000-5404.201701033
  CLC： R181.32; R445.1; R593.2
- Received：01 January 2017，
  
  Revised：2017-01-20，
  
  Published：30 May 2017
- 稿件说明：
移动端阅览
Shiwen Li, Jiao Shi, Xing Hua, et al. Value of an ultrasonographic scoring system in diagnosis of Sjögren's syndrome[J]. Journal of Third Military Medical University, 2017, 39(10): 996-1000.
DOI：

Shiwen Li, Jiao Shi, Xing Hua, et al. Value of an ultrasonographic scoring system in diagnosis of Sjögren's syndrome[J]. Journal of Third Military Medical University, 2017, 39(10): 996-1000. DOI： 10.16016/j.1000-5404.201701033.

摘要

目的

评价唾液腺半定量超声评分系统在干燥综合征（Sjögren’ s syndrome，SS）中的诊断价值。

方法

2014年6月至2016年6月于西南医院风湿免疫科怀疑为SS的98例患者纳入研究，男性35例，女性63例，年龄35 ~ 72岁，平均（52. 3 ± 19. 8）岁。回顾性分析其腮腺和颌下腺超声检查灰阶与彩色多普勒血流显像声像图表现，将其分为0 ~ 4级，获得相应评分，绘制受试者工作特征曲线（receiver operating curve，ROC），计算曲线下面积（area under curve，AUC），评价其诊断价值。对唾液腺超声评分左右侧之间的差异进行比较。对工作经验分别为10年和2年的两名医师评分一致性进行检验。

结果

98例患者中53例确诊为SS，45例被排除。唾液腺超声评分所形成ROC曲线AUC为0. 892。以2为截断点，唾液腺超声评分法诊断SS的敏感性为94. 34%，特异性为88. 89%，阳性预测值为90. 91%，阴性预测值为93. 02%。腮腺和颌下腺超声评分左右侧之间无显著差异性（

＞0.05）。不同工作经验的两名医师评分一致性分析Kappa值0. 884（

＜0.05）。

结论

唾液腺超声0-4级半定量评分系统对SS具有较高的诊断价值，且观察者一致性好，可用于SS的临床诊断。

Abstract

Objective

To evaluate the value of a semi-quantitative ultrasonographic scoring system of the salivary glands in the diagnosis of Sjögren' s syndrome (SS).

Methods

Ninety-eight patients with a suspected diagnosis of SS in the Southwest Hospital between June 2014 and June 2016 were included in the study. The imaging findings by grey-scale ultrasound and color Doppler ultrasonography of the salivary glands were analyzed and graded according to a 5-point (0 ~ 4) ultrasonographic scoring system. The receiver-operating curve (ROC) was drawn and the area under curve (AUC) was calculated to test the diagnostic performance of this scoring system for SS. The difference in the scores between the bilateral salivary glands was analyzed

and the inter-observer agreement in scoring was tested between two physicians with 10 and 2 years of ultrasound experiences.

Results

Among the 98 patients

a definite diagnosis of SS was established in 53 patients

and SS was excluded in the other 45 cases. The AUC of the ROC for the ultrasonographic scores of the salivary glands was 0. 892. The sensitivity

specificity

positive predictive value and negative predictive value of this system for SS diagnosis

with the score of 2 as the cut-off point

were 94. 34%

88.89%

90. 91% and 93. 02%

respectively. No significant difference was found in the scores between the bilateral salivary glands (

0.05)

and the Kappa value of the inter-observer agr

eement was 0. 884 (

0.05).

Conclusion

The semi-quantitative ultrasonohraphic scoring system of the salivary glands has a good diagnostic value for SS with a good inter-observer agreement

and can be used for clinical diagnosis of SS.

关键词

Keywords

references

Vitali C, Bombardieri S, Jonsson R, et al. Classification cri-teria for Sjögren' s syndrome: a revised version of the Europe-an criteria proposed by the American-European Consensus Group [ J]. Ann Rheum Dis, 2002, 61(6): 554-558. DOI: 10.1136/ard.61.6.554.

Goules A V, Tzioufas A G. Imaging: diagnostic value of ul-trasonography in Sjögren' s syndrome [J]. Nat Rev Rheuma-tol, 2014, 10(8): 450-452. DOI: 10.1038/nrrheum.2014.86.

Takagi Y, Kimura Y, Nakamura H, et al. Salivary gland ul-trasonography: can it be an alternative to sialography as an imaging modality for Sjogren' s syndrome?[ J]. Ann Rheum Dis,2010, 69(7): 1321-1324. DOI: 10.1136/ard.2009.123836.

Jonsson M V, Baldini C. Major Salivary Gland Ultrasonogra-phy in the Diagnosis of Sjögren' s Syndrome: A Place in the Diagnostic Criteria?[J]. Rheum Dis Clin North Am, 2016, 42(3): 501-517. DOI: 10.1016/j.rdc.2016.03.008.

王依宁, 王学梅, 欧国成.干燥综合征患者的颌下腺超声表现[J].中国超声医学杂志, 2012, 28(1): 23-26. DOI: 10.3969/j.issn.1002-0101.

Wang Y N, Wang X M, Ou G C. Ultrasonography of subman-dibular glands in patients with sjögren' s syndrome [J]. Chi-nese J Ultrasound Med, 2012, 28(1): 23-26. DOI: 10.3969/j.issn.1002-0101.

Baldini C, Luciano N, Mosca M, et al. Salivary Gland Ultra-sonography in Sjögren' s Syndrome: Clinical Usefulness and Future Perspectives [J]. Isr Med Assoc J, 2016, 18(3-4): 193-196.

Luciano N, Baldini C, Tarantini G, et al. Ultrasonography of major salivary glands: a highly specific tool for distinguishing primary Sjögren' s syndrome from undifferentiated connective tissue diseases [J]. Rheumatology(Oxford), 2015, 54(12): 2198-2204. DOI: 10.1093/rheumatology/kev253.

Cornec D, Jousse-Joulin S, Devauchelle-Pensec V, et al. Salivary gland ultrasonography improves the diagnostic per-formance of the 2012 American College of Rheumatology clas-sifcation criteria for Sjögren' s syndrome [J]. Rheumatology(Oxford), 2014, 53(9): 1604-1607. DOI: 10.1093/rheumatology/keu037.

Milic V D, Petrovic R R, Boricic I V, et al. Major salivary gland sonography in Sjögren' s syndrome: diagnostic value of a novel ultrasonography score(0-12) for parenchymal inho-mogeneity [J]. Scand J Rheumatol, 2010, 39(2): 160-166. DOI: 10.3109/03009740903270623.

Saied F, Włodkowska-Korytkowska M, Mas′lińska M, et al. The usefulness of ultrasound in the diagnostics of Sjögren' s syndrome [J]. J Ultrason. 2013, 13(53): 202-11. DOI: 10.15557/JoU.2013.0020.

Zhang X, Zhang S, He J, et al. Ultrasonographic evaluation of major salivary glands in primary Sjögren' s syndrome: comparison of two scoring systems [J]. Rheumatology(Ox-ford), 2015, 54(9): 1680-1687. DOI: 10.1093/rheu-matology/kev103.

周明珠, 宋淑菊, 段婷.干燥综合征涎腺超声评分系统及临床应用价值[J].中国实用内科杂志, 2016, 36(9): 810-813. DOI: 10. 7504/nk2016080703.

Zhou M Z, Song S J, Duan T. Scoring system of salivary gland ultrasonography in Sjögren' s syndrome and its clinical value [J]. Chinese J Practical Med, 2016, 36(9): 810-813. DOI: 10.7504/nk2016080703.

Takagi Y, Sumi M, Nakamura H, et al. Ultrasonography as an additional item in the American College of Rheumatology classification of Sjögren' s syndrome [J]. Rheumatology(Oxford), 2014, 53(11): 1977-1983. DOI: 10.1093/rheumatology/keu238.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Diagnostic value of endoscopic LCPL sign for high-risk intestinal metaplasia in gastric mucosa

Construction of a diagnostic model for chronic mountain sickness among young male migrants to high-altitude areas

Congenital inner ear deformity with spontaneous cerebrospinal fluid leakage: a case series report of 9 children

Application of Hess automatic screen recording system in diagnosis of acquired paralytic strabismus

Clinical significance of diagnosis and classification of ratio of hsa a_circ_0001708 to IKZF1 for pediatric B-ALI

Related Author

ZHENG Xipeng

PAN Huilin

WU Linyu

HOU Yongying

LIU Qin

MA Qiang

QIN Xiuyuan

LIU Kaijun

Related Institution

Department of Gastroenterology， Chongqing Key Laboratory of Precise Prevention and Treatment of Digestive Malignancies

Department of Pathology， Army Medical Center of PLA/Daping Hospital of Third Military Medical University， Chongqing

First Clinical College of Chongqing Medical University

Department of High Altitude Physiology and Pathology, Faculty of High Altitude Military Medicine， Army Medical University （Third Military Medical University）

Department of Medicine and Hygienic Equipment for High Altitude Region, Faculty of High Altitude Military Medicine， Army Medical University （Third Military Medical University）

⁰