Study The Diagnostic Value Of Salivary Glands By Ultrasonography In Sjogren's Syndrome

Objective: Sjogren's syndrome(SS) is a chronic inflammatory systemic autoimmune disease that predominantly affects exocrine glands such as salivary glands and lacrimal glands. It's a common disease. But at present, there is no single test which is sufficiently sensitive and specific to form the basis for the diagnosis of SS. The purpose of the study was to evaluate the efficacy of quantitatively ultrasonography of salivary and ultrasonography sialography in the diagnosis of SS.Metheds: First part: Thirty-two patients with SS were separated into two groups .There were 20 cases in earlier-period group and 12 cases in advanced-period group. There were twenty-seven cases in control group. All of them were underment examination of color Doppler flow imaging(CDFI) and two-dimensconal ultrasonography, size were checked . When the anteries of the glands were checked with CDFI , peak systolic velocity(PSV),end diastolic velocity(EDV),resistant index(RI) were observed. Second part: Stimulation test with vitamin-c was performed on 18 patients in SS group and 13 persons in control group. The changes of the blood flow that may occur before and after the stimulation were measured .Third part: Sixteen cases in SS group and 18 cases in control group were undertook both ultrasonography sialography and X-ray sialography. Results: 1.Compaired between the two group, different degrees of parenchymal inhomogeneity were the most important sonographic changes in SS (p<0.05). 2. The volume of salivary glands was larger in earlier group than in advanced group. While the volume of that in advanced group are smaller than in the control group (p<0.05). But the diameters of tubes were not significantly wider than that in the control group (p>0.05). 3.The values of PSV in salivary glands are significantly higher in the earlier group than in the control group(p>0.05). While the values of EDV,RI were not significant in statistics. In advanced group the values of PSV ,EDV were lower than that of control group(p<0.05). The values of RI were not significant in statistics(p>.05). 4. After the vitamin-C stimulation test the value of increase of PSV in parotid glands and PSV,EDV in submandebular glands in the group of SS patients were lower than that of control group(p<0.05).The value of increase of EDV ,RI in parotid glands and RI in submandbular glands in the group of SS patients were similar to that of control group(p>0.05).5.The accurate ratios in diagnosis of SS were the same in the whole between the ultrasonography sialography and X-ray sialography.Conclution: Color doppler ultrasonography of salivary glands is useful and convenient in the diagnosis of SS. The acidity stimulation test can be used to diagnose those cases worthing questioning .Ultrasound sialography is a alternative method which is the same as the classical X-ray sialography in validity. So we suggest Ultrasonography is helpful to the diagnosis of SS.