ISSN : 2146-3123
E-ISSN : 2146-3131

Quantitative Assessment of Salivary Gland Parenchymal Vascularization Using Power Doppler Ultrasound and Superb Microvascular Imaging: A Potential Tool in the Diagnosis of Sjögren"s Syndrome
Fethi Emre Ustabaşıoğlu1, Selçuk Korkmaz2, Ufuk İlgen3, Serdar Solak1, Osman Kula1, Sezin Turan3, Hakan Emmüngil3
1Department of Radiology, Trakya University Faculty of Medicine, Edirne, Turkey
2Department of Biostatistics and Medical Informatics, Trakya University Faculty of Medicine, Edirne, Turkey
3Department of Rheumatology, Trakya University Faculty of Medicine, Edirne, Turkey
DOI : 10.4274/balkanmedj.galenos.2020.2019.11.91

Background: Primary Sjögren's syndrome (pSS) is a chronic inflammatory autoimmune disease. Minor salivary gland biopsy is gold standard for pSS diagnosis. Superb microvascular imaging (SMI), power Doppler ultrasound (PDUS) and color Doppler of salivary gland represent non-invasive, non-irradiating modality for evaluation the vascularization of salivary gland in the diagnosis and follow-up of pSS.
Aims: To evaluate the efficacy of SMI and vascularity index (VI) in salivary glands for sonographic diagnosis of pSS.
Study Design: Prospective case-control study.
Material and Methods: 20 participants with pSS and 20 healthy subjects were included in the study. Both parotid glands (PG) and submandibular glands (SG) were evaluated by SMI, PDUS, color Doppler and diagnostic accuracy of SMI was compared with these techniques.
Results: In patients group VI values of SMI in PG and SG were 3.5 ± 1.66, 5.06 ± 1.94, respectively. While same values were 1.0 ± 0.98, 2.44 ± 1.34 in control group (p 0.001). In patients group VI values of PDUS in PG and SG were 1.3 ± 1.20, 2.59 ± 1.82, respectively. While same values were 0.3 ± 0.32, 0.85 ± 0.68 in control group (p 0.001). SMI VI cut-off value for pSS diagnosis in PG that maximizes the accuracy was 1.85 (AUC: 0.906; 95 % CI 0.844, 0.968), and its sensitivity and specificity were 87.5 % and 72.5 %, respectively. Whereas SMI VI cut off value for pSS diagnosis in SMG that maximizes the accuracy was 3.35 (AUC: 0.873; 95 % CI 0.800, 0.946), its sensitivity and specificity were 82.5%, 70%, respectively.
Conclusions: SMI has higher sensitivity and specifity than PDUS in the diagnosis of pSS. Quantitative SMI VI values, with their high reproducibility, could become a non-invasive useful technique in diagnosis of pSS with clinical parameters, laboratory findings, and other imaging modalities such as gray-scale ultrasound and PDUS.

Keywords : Power Doppler ultrasound salivary glands, primary Sjögren"s syndrome, superb microvascular imaging, ultrasonography
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