Effectiveness of ultrasonography and shear wave sonoelastography in Sjogren's syndrome with salivary gland involvement
Yunus Emre Oruk1 , Mehmet Burak Çildağ2 , Can Zafer Karaman3 , Songül Çildağ4
1Muğla Menteşe State Hospital, Muğla, Turkey
2Department of Diagnostic and Interventional Radiology, Adnan Menderes University Training and Research Hospital, Aydın, Turkey
3Department of Diagnostic and Interventional Radiology, Adnan Menderes University Training and Research Hospital, Aydın, Turkey
4Department of Immunology and Allergy, Adnan Menderes University Training and Research Hospital, Aydın, Turkey
Corresponding Author: Yunus Emre Oruk ,Tel: +90-534-7173915, Fax: +092522132025, Email: dr.yunusemreoruk@hotmail.com
Received: January 19, 2021;  Accepted: March 23, 2021.  Published online: March 23, 2021.
ABSTRACT
Purpose:
The aim of this study was to investigate the effectiveness of major salivary gland ultrasonography(MSGUS) by using new grading system and shear wave elastography (SWE) in evaluating the major salivary glands of patients with Sjögren’s Syndrome(SjS). Material and
Methods:
This prospective designed cross sectional study included 49 SjS patients and 49 healthy controls. Major salivary glands were examined by gray scale ultrasonography and SWE. A new grading system for salivary glands was made by using MSGUS findings. The sensitivity, specificity, positive predictive value(PPV), and negative predictive value(NPV) of MSGUS and shear wave velocity(SWV) values was investigated. Also, MSGUS grading system and SWV values were evaluated together by logistic regression modeling. A cutoff value of SWE for salivary glands was determined.
Results:
The sensitivity, specificity, PPV, and NPV of MSGUS for submandibular gland were 69.4%, 73.5%, 72.3%, 70.6% and for parotid gland were 69.4%, 65.3%, 66.7%, 68.1%, respectively. The mean SWV values of parotid and submandibular glands were significantly higher in SjS patients than control group (p<0.05). The sensitivity, specificity, PPV, and NPV for submandibular gland (the cutoff value:1.95 m/s) and for parotid gland (the cutoff value:2.39 m/sn) were 69.4%,52%,59.1%,63% and 82.7%,83.7%,83.5%,82.8%, respectively. Sensitivity and specificity increased when SWE was added to grading system in parotid gland (sensitivity:82.7%, specifity:83.7%).
Conclusion:
This study demonstrated that the evaluation of the salivary gland by MSGUS with new grading system and SWE may contribute to the diagnosis of SjS. Also the combination of MSGUS and SWE were found a promising tool in diagnosis of SjS.
Keywords: Parotid gland; Elastography; Submandibular gland; Ultrasonography
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