实时剪切波弹性成像联合超声评分在原发性干燥综合征
腮腺受损诊断中的价值

doi:10.12117/jccmi.2019.11.004

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摘要目的：探讨实时剪切波弹性成像（RT-SWE）联合超声评分对原发性干燥综合征（primary Sjogren’s syndrome，pSS）患者腮腺受损的诊断价值。方法：收集pSS疑诊患者140例，根据其最终诊断结果，将患者分为pSS组76例，非pSS组64例。对所有患者进行双侧腮腺超声检查，采用半定量评分方法评分。RT-SWE获得其杨氏模量（E）平均值（Emean）。比较两组间腮腺超声评分和Emean，以及二者联合对pSS腮腺受损的诊断效能，并绘制ROC曲线。结果：①pSS组超声评分高于非pSS组（P＜0.001），ROC曲线示：超声评分诊断pSS腮腺受损的最佳截断值为2，敏感性、特异性分别为81.6%和93.7%，曲线下面积（AUC）为0.906。②两组间左、右侧腺体Emean差异无统计学意义，pSS组腮腺Emean值明显高于非pSS组，差异具有统计学意义（P＜0.001）。ROC曲线示：RT-SWE诊断pSS腮腺受损的Emean最佳截断值为9.9 kPa，敏感性、特异性、AUC分别为75.0%、95.3%和0.876。③腮腺超声评分联合RT-SWE诊断pSS的敏感性、特异性、AUC分别为88.2%、90.6%和0.950。二者联合的AUC均大于超声评分及杨氏模量的AUC，差异具有统计学意义（P值分别为0.033、0.001）。结论：腮腺超声评分可为腺体回声的均匀程度提供半定量指标，RT-SWE可测量腮腺腺体硬度，二者联合评估pSS腮腺受损准确性高，值得临床推广。

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	王娇娇
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	齐清华
	董刚

关键词 ：干燥综合征, 腮腺, 超声检查

Abstract：Objective: To explore the diagnostic value of Young’s modulus by real-time shear wave elastography(RT-SWE) combined with sonographic score in parotid gland with primary Sjogren’s syndrome(pSS). Methods: One hundred and forty suspected Sjogren’s syndrome patients were enrolled in this study. The bilateral parotid gland was examined by ultrasonography and RT-SWE. Semiquantitative scores and the Young’s modulus were obtained. The differences of sonographic scores and Young’s modulus between two sides of parotid glands in pSS group and the non-pSS group were analyzed. And the diagnostic efficacy of sonographic scores combined with Emean in parotid gland damage of pSS was also analyzed, the ROC curve was plotted. Results: ①Sonographic score in pSS group was higher than non-pSS group(P<0.001). The ROC curve showed that the best cut-off value was 2, the sensitivity and specificity was 81.6% and 93.7%, respectively, and the area under the curve(AUC) was 0.906. ②The Young’s modulus between two sides of parotid glands in pSS group or non-pSS group showed no significant difference(P>0.05). The difference of Young’s modulus between the two groups was statistically significant(P<0.001). The ROC curve showed that the optimal cut-off value of Emean was 9.9 kPa, the sensitivity and specificity was 75.0% and 95.3%, respectively, and the AUC was 0.876. ③The sensitivity and specificity of parotid ultrasonography scores combined with RT-SWE for diagnosis of pSS was 88.2% and 90.6%, respectively, and the AUC was 0.950. The AUC of the combined score was greater than the AUC of the sonographic scores or Young’s modulus(P value was 0.033 and 0.001, respectively). Conclusion: The parotid sonographic scores can provide a semi-quantitative index for the uniformity of glandular echo. RT-SWE can measure the hardness of parotid gland. The combination of these two is highly accurate in the evaluation of parotid gland with pSS, which is worthy of clinical promotion.

Key words： Sjogren’s syndrome Parotid gland Ultrasonography

收稿日期: 2018-12-04

PACS:	Ｒ781.7
	Ｒ445.1

通讯作者: 董刚，郑州大学第一附属医院超声科，450052。E-mail：dgcsjr@126.com

作者简介: 王娇娇（1983-），女，河南安阳人，主治医师。E-mail：942460656@qq.com

引用本文:

王娇娇，张磊，刘升云，马笑，齐清华，董刚. 实时剪切波弹性成像联合超声评分在原发性干燥综合征腮腺受损诊断中的价值[J]. 中国临床医学影像杂志, 2019, 30(11): 773-777.
WANG Jiao-jiao, ZHANG Lei, LIU Sheng-yun, MA Xiao, QI Qing-hua, DONG Gang. The diagnosis value of RT-SWE combined with sonographic score in parotid gland damage of primary Sjogren’s syndrome. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(11): 773-777.

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http://www.jccmi.com.cn/CN/10.12117/jccmi.2019.11.004 或 http://www.jccmi.com.cn/CN/Y2019/V30/I11/773

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