Value of conventional ultrasound and shear wave elastography in assessing disease activity and prognosis in female patients with Sjögren's syndrome

Abstract

ObjectiveThis study aimed to assess the diagnostic value of labial salivary gland changes in female patients with Sjögren's syndrome (SS) having different European League Against Rheumatism (EULAR) Sjögren's syndrome disease activity index (ESSDAI) and serological markers using conventional ultrasound and shear wave elastography (SWE). Methods A total of 82 female inpatients diagnosed with SS were retrospectively examined at the First Affiliated Hospital of Soochow University from July 2020 to December 2021. The patients were divided into two groups based on the ESSDAI score: remission group (ESSDAI <5) and active group (ESSDAI ≥5). The prognosis of patients was assessed using serological markers. The ultrasound examination of bilateral labial glands was performed in all patients to analyze the quantity and area of the largest single labial gland per unit detection range (Smax). The SWE of labial glands was performed in different groups. ResultsThe Smax and quantity of labial glands on both sides were correlated with patient age in 82 female patients with SS. Emin, Emean and Emax of remission group based on ESSDAI were significant lower than active group (p<0.001), and the areas under the receiver operating characteristic(ROC) curve for these three in diagnosing were 0.720, 0.728 and 0.734, respectively. The differences in Emean, Emin and Emax values of labial gland between the two groups of immunoglobulin G (IgG) <16g/L and IgG ≥16g/L were statistically significant differences (p<0.05), and the area under the ROC curve(AUC) for the three values were 0.825, 0.830, and 0.815, respectively. There were statistically significant differences (p < 0.05) in Emin, Emean, and Emax of labial glands between the hypocomplementemic and non-hypocomplementemic groups, and the AUC for the three values were 0.840, 0.843, and 0.819, respectively. Conclusion Conventional ultrasound and SWE of the labial gland can reflect the disease activity and prognosis of patients with SS, andmore conveniently assess the progression in the patients and provide imaging evidence.

Sjögren's syndrome: one year in review 2023

“…Major SG SWE displayed a moderate inter-reliability (ICC=0.64), a moderate to good intra-rater reliability (ICC=0.73-0.83) and from good to excellent diagnostic performance (AUC=0.80-0.937) (30). Moreover, LSG SWE has been demonstrated to associate with disease activity, assessed by ESSDAI, IgG levels and hypocomplementaemia (31).…”

“…• The Outcome Measures in Rheumatology (OMERACT) semiquantitative scoring system was demonstrated to be a specific diagnostic tool, with good reproducibility and good inter-observer reliability also in the evaluation of SS labial and lacrimal salivary glands (26-28). • Major salivary gland shear wave elastography may be considered a novel tool in the evaluation of glandular tissue in SS patients (30,31). • Ultrasonography-guided core needle biopsy of major salivary gland has been confirmed as safe and noninferior to incisional biopsy whereas in labial salivary glands can provide larger samples (35,36).…”

UHFUS: A Valuable Tool in Evaluating Exocrine Gland Abnormalities in Sjögren’s Disease

“…In contrast to lacrimal glands, there is limited research available regarding conventional ultrasonography of labial salivary glands (Table 1). To date, only one study has focused on minor salivary glands, revealing how SWE values in patients with SjD are associated with disease activity measured by the ESSDAI (EULAR Sjögren's Syndrome Disease Activity Index), levels of IgG antibodies, and the presence of hypocomplementemia [33]. Research conducted by our group has yielded insights into the utility of ultra-high frequency ultrasound in assessing labial salivary glands [34].…”