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The Korean Journal of Medicine 2009;77(4): 480-487.
항 Ro/SS-A 항체 양성인 일차성 쇼그렌증후군 환자에서 침샘 초음파의 유용성
김영욱, 권성렬, 임미진, 김환철, 박 원
Ultrasonography of the salivary glands in primary Sjögren’s syndrome with positive anti Ro/SS-A antibody
Young Wook Kim, Seong Ryul Kwon, Mie Jin Lim, Hwan Cheol Kim, Won Park
This study sought to evaluate the diagnostic value of salivary gland ultrasonography in primary Sjögren’s syndrome with anti-Ro/SS-A antibody. The secondary goal was to assess the relationship between the grade of parenchymal inhomogeneity and the anti-Ro/SS-A antibody titer or clinical manifestations.
The parotid and submandibular glands were examined ultrasonographically in 30 patients having primary Sjögren’s syndrome with anti-Ro/SS-A antibody and 30 control subjects with no evidence of Sjögren’s syndrome. The ultrasonographic definition of parenchymal inhomogeneity of the salivary glands was blurred glandular borders, multiple hyperechoic bands, and hypoechoic areas. The parenchymal inhomogeneity of the glands was categorized into four grades.
Parenchymal inhomogeneity of the parotid gland was seen in 25 (83.3%) patients with primary Sjögren’s syndrome and 2 (6.7%) control subjects. Of these cases, the submandibular gland showed parenchymal inhomogeneity in 24 (80%) patients with primary Sjögren’s syndrome and 2 (6.7%) control subjects. The sensitivity and specificity of parenchymal inhomogeneity of the parotid gland were 83.3% and 93.3%, respectively, and 80% and 93.3% for the submandibular gland. The grade of ultrasonographic parenchymal inhomogeneity was related to a diagnosis of Sjögren’s syndrome (p<0.001) and the time of dissolution of the wafer, but had no relationship with the anti-Ro/SS-A antibody titer. A high degree of interobserver agreement was found in the assessment of parenchymal abnormalities of the salivary gland (parotid gland: κ=0.859; submandibular gland: κ=0.837).
Salivary gland ultrasonography is a useful method for visualizing glandular structural changes and making a diagnosis of primary Sjögren’s syndrome. (Korean J Med 77:480-487, 2009)
Keywords: Ultrasonography; Primary Sjö; gren’s syndrome; Salivary glands; Parenchymal inhomogeneity
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