Comparison of Clinical Characteristics and Magnetic Resonance Imaging of Salivary Glands With Magnetic Resonance Sialography in Sjögren's Syndrome

Abstract

Objectives/Hypothesis To compare the results of magnetic resonance imaging with magnetic resonance sialography (MRSIAL) and the clinical and laboratory characteristics in a well‐characterized cohort of patients with primary or secondary Sjögren's syndrome (SS) meeting the American–European Consensus Group criteria. Study Design: Retrospective, observational, monocentric study. Methods Thirty‐six patients (81% female, mean age = 48 ± 35 years) with primary or secondary SS who underwent MRSIAL were included in the study. Results MRSIAL revealed characteristic radiological signs in the parotid, sublingual, and submandibular salivary glands in 35/36 patients (97%). Patients presenting with anti‐Sjögren's syndrome–related antigen A (SSA) autoantibodies showed more often fatty infiltration, a “pepper‐and‐salt” appearance, ductal stenosis, and/or ductal dilation of the parotid gland (88%, 88%, and 72% respectively) than patients negative for anti‐SSA (12%, 4%, and 28% respectively). MRSIAL demonstrated signs characteristic of SS in all 11 patients with negative minor salivary gland biopsy. For 15 patients undergoing ultrasound examination only, 11 (73%) had SS findings, but all 15 had SS findings on MRSIAL. Two cases of parotid lymphoma were detected by MRSIAL (6%). Conclusions MRSIAL is a reliable technique to detect glandular anomalies in patients with SS, and seems to provide a valuable aid in the diagnosis of SS. Level of Evidence 4 Laryngoscope, 131:E83–E89, 2021

Correlations of MR Sialographic Gradings with the Clinical Measures of Sjögren's Syndrome

“…24 André et al recently showed that ductal ectasia/stenosis was mainly seen in the PGs, and this "leafless fruit-laden tree aspects (apple-tree appearance)" was correlated with anti-SSA-positivity, with high sensitivity (97%). 4 They also found that fatty infiltration with "pepper-and-salt aspects" and globular atrophy in SMGs were seen in advanced SS cases. Kojima et al also showed that multiple high-signal-intensity spots showed high diagnostic performance for SS, particularly with 100% specificity in SMGs.…”

“…26 We could not observe the correlations of MR geographic findings with lymphocyte infiltration in the MSGB results, possibly due to technical issues depending on the sample quality and the limited number of samples. 4 The correlations of immune reactions in salivary glands with structural alterations and glandular degeneration remain unclear.…”

“…In contrast, conventional sialography is an irradiating and invasive procedure that may cause allergic reactions and ductal injury. [2][3][4] Furthermore, MR sialography provides additional information by simultaneously observing features from all three pairs of major salivary glands: the parotid gland (PG), submandibular gland (SMG), and sublingual gland, as well as the lacrimal gland. 5 Moreover, it provides indirect functional information after stimulating salivary gland secretion with a sialogogue.…”

Correlation Between Salivary Microbiome of Parotid Glands and Clinical Features in Primary Sjögren’s Syndrome and Non-Sjögren’s Sicca Subjects

“…MR sialography revealed that sialectasis in PG ducts and fat deposition in SMGs were the characteristic features of the SS sicca group. Apple tree-like appearance resulting from sialectactic structural changes was often observed in the PG ducts ( 40 ). Consistently, the microbiome composition was significantly correlated with the radiological findings of the SS sicca group.…”

The Diagnostic Value of MRI-Based Radiomic Analysis of Lacrimal Glands in Patients with Sjögren’s Syndrome

“…Ultrasonography of the parotid gland represents the most widely used method in assessing parenchymal changes, clinical activity [ 7 ], and the response to therapy [ 8 ]. Magnetic resonance imaging (MRI) is also used in evaluating patients with pSS; MRI sialography represents the gold standard imaging technique in staging the disease [ 9 ]. The imaging aspect of the parotid and submandibular glands consists of diffuse parenchymal changes, with progressive acinar atrophy and the presence of multiple cystic areas that correspond to the ectasia of the salivary ducts.…”