Sonoelastographic Modalities in the Evaluation of Salivary Gland Characteristics in Sjögren's Syndrome

Hofauer, Benedikt; Mansour, Nashat; Heiser, Clemens; Gahleitner, Constanze; Thuermel, Klaus; Baş, Murat; Knopf, Andreas

doi:10.1016/j.ultrasmedbio.2016.04.011

Cited by 50 publications

(50 citation statements)

References 40 publications

(49 reference statements)

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“…1 ). They concluded that US examination represents another test for salivary gland involvement in SS [18,[21][22][23][24][25][26][27][28] .…”

Section: Diffuse Parotid Gland Diseasesmentioning

confidence: 99%

“…In particular, SWE provides a reliable and non-invasive assessment of tissue stiffness. Hofauer et al [22] evaluated different elastographic techniques and concluded that SE could not add any further information compared to B-mode US for the evaluation of salivary gland involvement in SS, but that SWE was the most promising technique. The values for the parotid glands in an SS population were significantly higher than the values for the parotid glands in a control group ( Fig.…”

Section: Diffuse Parotid Gland Diseasesmentioning

confidence: 99%

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Ultrasound Elastography in Diffuse and Focal Parotid Gland Lesions

Mansour

Hofauer

Knopf³

2017

ORL

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In Europe, ultrasound (US) is the diagnostic gold standard for the visualisation of parotid gland disorders. While high-resolution B-mode US reliably visualises focal lesions, its diagnostic capacity to distinguish tumour entities or to characterise diffuse lesions remains poor. Strain elastography (SE) and shear wave elastography (SWE) are novel imaging techniques that provide additional information about tissue elasticity. SE analyses the strain or displacement in response to force or compression and, therefore, shows the relative tissue elasticity within a selected region of interest (ROI). Recent studies suggest that SE might be able to predict parotid gland malignancy. In SWE, push pulses generate localised displacements within an ROI that describes mechanical tissue properties expressed in absolute values. Recent studies indicate that SWE can predict tissue fibrosis in different organs. This review article highlights the current role of SE and SWE modalities in diffuse and focal changes of the parotid gland.

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“…1 ). They concluded that US examination represents another test for salivary gland involvement in SS [18,[21][22][23][24][25][26][27][28] .…”

Section: Diffuse Parotid Gland Diseasesmentioning

confidence: 99%

Section: Diffuse Parotid Gland Diseasesmentioning

confidence: 99%

Ultrasound Elastography in Diffuse and Focal Parotid Gland Lesions

Mansour

Hofauer

Knopf³

2017

ORL

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“…SS is a chronic autoimmune disorder that primarily affects the lacrimal and salivary glands, and therefore keratoconjunctivitis sicca, xerostomia, and recurrent salivary gland enlargement represent the typical clinical symptoms [2][3][4] . SS predominantly affects middleaged women, with a reported incidence of 3-11 cases per 100,000 persons and a reported prevalence between 0.01 and 0.72% [5][6][7] .…”

Section: Sjögren Syndromementioning

confidence: 99%

Biomarkers in Autoimmune Salivary Gland Disorders: A Review

Hofauer

Thuermel

Gahleitner

et al. 2017

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Salivary glands are frequent sites of manifestations of autoimmune disorders in the head and neck. Sjögren syndrome, sarcoidosis, granulomatosis with polyangiitis, and IgG4-related sialadenitis represent the most important autoimmune salivary gland disorders. Due to the lack of specific symptoms, diagnosis of these conditions remains a challenge. Diagnosis is usually based on classification criteria involving clinical tests, histopathological evaluation, and serological examinations. Depending on the disease, biomarkers are of different value and have to be interpreted carefully. In Sjögren syndrome, antibodies against Ro/SS-A and La/SS-B are essential and part of established classification criteria. In sarcoidosis, biomarkers such as angiotensin-converting enzyme, serum amyloid A, adenosine deaminase, and soluble interleukin-2 receptor are not suitable to confirm a diagnosis due to low sensitivity and specificity, but allow a differentiation between active and inactive disease. In patients with suspected granulomatosis with polyangiitis, positivity for anti-neutrophil cytoplasmic antibodies (ANCA) allows a diagnosis without histopathological confirmation in selected cases. In the head and neck, limited manifestations are common, in which less patients are positive for ANCA and histopathological confirmation is required. Diagnosis of IgG4-related sialadenitis solely based on elevated IgG4 serum levels is not possible. The concentration of blood plasmablasts is reported to have a higher diagnostic value.

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“…These tools have the disadvantages of variability in sensitivity and specificity rates, exposure to radioactive materials or complications of invasive procedures. 5 Past studies using ultrasound (US) imaging for the diagnosis of SS have shown promising results. 6 However, US evaluation in most of those studies was visual and therefore, subjective.…”

mentioning

confidence: 99%

“…7 There are also studies in the literature using US elastography of salivary glands for the diagnosis of SS based on the tissue stiffness, which is a prominent feature of the diseased glands due to the fibrotic changes associated with the disease. 5 To the best of our knowledge, there is no study in the literature that has quantified the echogenicity of the glands with gray-scale histogram analysis and the stiffness of glands using sonoelastography and then correlated these results with histopathological findings in patients with SS. Therefore, in this study, we aimed to evaluate gray-scale histogram analysis of B-mode US images and US elastographic features of the parotid glands in patients with SS and to explore relationships with the ultrasonographic and disease activity scores in the light of histopathological findings.…”

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confidence: 99%

The Role of Real-Time Tissue Elastography and Gray-Scale Ultrasound Histogram Analysis in the Diagnosis of Patients With Sjögren’s Syndrome

et al. 2019

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Objectives: This study aims to evaluate gray-scale histogram analysis of B-mode ultrasound (US) images and US elastographic features of the parotid glands in patients with Sjögren's syndrome (SS) and to explore relationships with the ultrasonographic and disease activity scores in the light of histopathological findings. Patients and methods: A total of 57 consecutive female patients (mean age 47.9±10.4 years; range 25 to 76 years) with a diagnosis of SS and 48 healthy female individuals (mean age 51.1±10.8 years; range 20 to 70 years) underwent parotid ultrasonography and real-time tissue elastography imaging. Quantitative measurements of gray-scale US images were performed using the histogram software of the scanner. The histogram ratios of the parotid glands from both sides were obtained (histogram ratio; mean gray-scale histogram parotid/mean gray-scale histogram fat). Strain ratio (SR; ratio of fat to gland parenchyma) was calculated from the color-coded images. Subjective B-mode US scoring of electronically recorded grayscale US images was performed by two radiologists independently for intra-and inter-observer agreement. Subjective assessments, quantitative measurements, and clinical parameters were compared. Results: The SR of the patient group (1.4±0.8 right side, 1.5±0.9 left side) was significantly higher than that of the control group (1.0±0.3 right side, 1.1±0.3 left side) (p<0.05). The gray-scale histogram ratio of the patient group (1.3±0.5 right side, 1.4±0.9 left side) was lower than that of the control group (1.8±0.7 right side, 1.9±0.7 left side) (p<0.05). Receiver-operating-characteristics curve yielded 66% sensitivity for both sides and 50% and 52% specificity for the right and left sides, respectively, for a cut-off SR of 1.02; 76% and 86% sensitivity for the right and left sides, respectively, and 63% specificity for both sides for a cut-off histogram ratio of 1.35. The quantitative histogram ratio method had a higher positivity rate for the diagnosis of abnormal parotid glands than subjective assessments of US images. Conclusion: Sonoelastography and gray-scale histogram analysis of the parotid glands may be used as auxiliary tools to detect parotid gland sonographic abnormalities in patients with SS.

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Sonoelastographic Modalities in the Evaluation of Salivary Gland Characteristics in Sjögren's Syndrome

Cited by 50 publications

References 40 publications

Ultrasound Elastography in Diffuse and Focal Parotid Gland Lesions

Ultrasound Elastography in Diffuse and Focal Parotid Gland Lesions

Biomarkers in Autoimmune Salivary Gland Disorders: A Review

The Role of Real-Time Tissue Elastography and Gray-Scale Ultrasound Histogram Analysis in the Diagnosis of Patients With Sjögren’s Syndrome

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