Ultrasonographic Changes of Major Salivary Glands in Primary Sjögren’s Syndrome

Abstract

We aimed to evaluate the changes over time in salivary gland (SG) abnormalities by ultrasound (US) in patients with primary Sjögren's syndrome (pSS). Patients with pSS (n = 70) and idiopathic sicca syndrome (n = 18) underwent baseline salivary gland ultrasound (SGUS) scans, and follow-up scans two years later. The semi-quantitative SGUS score (0-48) and intraglandular power Doppler signal (PDS) were assessed. We found that in the pSS group, the SGUS scores for total SGs and bilateral parotid glands significantly increased after the median 23.4-months follow-up. SGUS scores either worsened, improved, or were stable in 18.6%, 2.9%, and 78.6% of patients with pSS, respectively. The median changes from baseline in SGUS scores for total and parotid glands were +1.0 and +0.5, respectively. None of the SGUS scores changed significantly in the controls. The variables of homogeneity and hypoechoic showed a statistically significant progression of SGUS scores. In pSS patients, the baseline and follow-up PDS scores were significantly higher in the "worsening" group than in the "no change/improvement" group. Overall, the structural abnormalities in major SGs assessed using SGUS remained stable in patients with pSS. At the 2-year follow-up, SGUS scores worsened in 18.6% of patients with pSS. Intra-glandular hypervascularity was associated with the worsening of SG abnormalities.

Ultrasonographic characteristics of major salivary glands in anti-centromere antibody-positive primary Sjögren’s syndrome

“…Also, higher SGUS score was associated with poor response to rituximab [ 22 ]. Among the SGUS scoring components, the extent of hyperechoic foci has shown significant positive association with USFR [ 13 ], and PDUS has shown predictive value for SGUS progression in 2-year follow up data [ 23 ]. In addition, SGUS of hypoechoic area significantly progressed in pSS patients [ 23 ].…”

“…Among the SGUS scoring components, the extent of hyperechoic foci has shown significant positive association with USFR [ 13 ], and PDUS has shown predictive value for SGUS progression in 2-year follow up data [ 23 ]. In addition, SGUS of hypoechoic area significantly progressed in pSS patients [ 23 ]. Patients with pSS who had systemic manifestation (peripheral neuropathy or leucocytoclastic vasculitis or interstitial lung disease or lymphadenopathy or arthritis) had higher SGUS score [ 24 ].…”

Ultrasound examination of the salivary glands in Sjogren’s disease

“…Проспективное исследование по схожему дизайну было проведено японскими авторами [40]. Особенностью этой работы была иммуносупрессивная терапия, проводимая между двумя УЗИ СЖ.…”

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“…Also, higher SGUS score was associated with poor response to rituximab [22]. Among the SGUS scoring components, the extent of hyperechoic foci has shown significant positive association with USFR [13], and PDUS has shown predictive value for SGUS progression in 2-year follow up data [23]. In addition, SGUS of hypoechoic area significantly progressed in pSS…”

“…patients [23]. Patients with pSS who had systemic manifestation (peripheral neuropathy or leucocytoclastic vasculitis or interstitial lung disease or lymphadenopathy or arthritis) had higher SGUS score [24].…”