核磁造影显示腮腺多个高信号斑点是诊断干燥综合征最好的指标

作者：Kojima I , et al.

翻译：北医三院 金银姬 （[e-mail]）

校对：北医三院 武东

摘要：目的：我们分析了腮腺、颌下腺和舌下腺核磁结果对区分干燥综合征和非干燥综合征的诊断价值。

方法：我们回顾性分析临床疑诊干燥综合征的69名患者磁共振成像和病理结果的相关性。我们评估了在T1和T2加权像的不同信号强度分布，核磁唾液腺造影摄片中多个高信号强度斑点及腮腺、颌下腺、舌下腺的体积。

结果：腮腺的多个高信号强度斑点表现出高灵敏度和诊断准确率 (分别为82% 和 83%)。此外，多个高信号强度斑点和颌下腺不同信号强度分布存在高特异性 (分别为100%和88%)。颌下腺体积在干燥综合征患者中减少。腮腺、舌下腺体积无减少。

结论：核磁造影显示腮腺多个高信号斑点应作为诊断干燥综合征最好的指标。斑点、异质性的存在和颌下腺体积变小因其特异性高，特别是在疾病进展的病例中，因此有助于诊断。

附原文：Abstract OBJECTIVE: We analyzed the diagnostic performance of the MR imaging findings of the parotid, submandibular, and sublingual glands to discriminate between patients with and without Sjögren's syndrome.METHODS:

We retrospectively analyzed the correlation between the MR imaging and histopathological findings obtained from 69 patients with clinically suspected Sjögren's syndrome. We evaluated the heterogeneous signal intensity distribution on T1- and T2-weighted images, the multiple high-signal-intensity spots on MR sialograms, and the volume of the parotid, submandibular, and sublingual salivary glands. RESULTS:The multiple high-signal-intensity spots in the parotid gland showed the highest sensitivity and diagnostic accuracy (82% and 83%, respectively). In addition, the multiple high-signal-intensity spots and the heterogeneous signal intensity distribution in the submandibular gland showed high specificity (100% and 88%, respectively). The volume of the submandibular gland, but not that of the parotid or sublingual gland, was smaller in patients with Sjögren's syndrome. CONCLUSIONS:The presence of multiple high-signal-intensity spots on an MR sialogram in the parotid gland should be considered the best diagnostic indicator for Sjögren's syndrome. The presence of spots, heterogeneity, and the change to smaller volumes in the submandibular gland were also helpful because of their high specificity, particularly in advanced cases. 

引自：Kojima I, Sakamoto M, Iikubo M, et al. Diagnostic Performance of MR Imaging of Three Major Salivary Glands for Sjögren's Syndrome. Oral Dis. 2016 Aug 31. doi: 10.1111/odi.12577. [Epub ahead of print]