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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
[华兴, 电话:(023)68765439,E-mail:huaxing_ultra@163.com Hua Xing, Tel: 86-23-68765439, E-mail: huaxing_ultra@163.com
收稿:2017-01-01,
修回:2017-01-20,
纸质出版:2017-05-30
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李世文, 石娇, 华兴, 等. 超声评分系统在干燥综合征中的诊断价值[J]. 第三军医大学学报, 2017,39(10):996-1000.
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.
李世文, 石娇, 华兴, 等. 超声评分系统在干燥综合征中的诊断价值[J]. 第三军医大学学报, 2017,39(10):996-1000. DOI: 10.16016/j.1000-5404.201701033.
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.
目的
2
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
2
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
2
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(
P
>0.05)。不同工作经验的两名医师评分一致性分析Kappa值0. 884(
P
<0.05)。
结论
2
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。
Objective
2
To evaluate the value of a semi-quantitative ultrasonographic scoring system of the salivary glands in the diagnosis of Sjögren' s syndrome (SS).
Methods
2
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
2
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 (
P
>
0.05)
and the Kappa value of the inter-observer agr
eement was 0. 884 (
P
<
0.05).
Conclusion
2
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.
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