The Application Value Of Real-time Shear Wave Elastography In Salivary Gland Manifestation Insjogren Syndrome

Objective:1.The Young's modulus(YM)of the major salivary glands in sjogren's syndrome(SS)were measured by real-time shear wave elastography(SWE),and To asses the value of real-time shear wave elastorgraphy(SWE)in the diagnosis of sjogren syndrome.2.To investigate the value of real-time shear wave elastography(SWE)in evalution on parotid function in sjogren's syndrome(SS)patients.Methods:We study 227 patients with suspected SS who were seen at the rheumatology outpatient clinic or inpatient as the experimental group.The experimental group were divided into SS groups 100 cases and non SS groups 127cases according to the American-European Consensus Group(AECG)classification standard.all cases were checked with SWE,records dates refers to Young's modulus Emean of bilateral salivary glands.The differences of bilateral parotid and submandibular glands in the two groups were compared and the value of the technique in the diagnosis of SS salivary gland lesions was analyzed.Acoording to parotid function evaluated using scintigraphy,100 SS patients were divided into four groups(normal group 6 cases,mild group 25cases,moderate group 39 cases and severe group 30 cases).The difference of Young's modulus among four groups were compared and the correlation were analyzed between Young's modulus and paratid glands function.and to evaluate the value of parotid function.Results:1.The differences of YM Emean between the two sides of parotid gland and submaxillary gland were not statistically significant(p>0.05),The parotid and submandibular gland YM Emean between the SS group and the non SS group had statistical difference(p<0.05).The YM Emean of major salivary glands in SS group were greater than non SS group.2.Taking the partotid glands'YM Emean was 20.00 kPa as threshold,the area under the ROC curve of SWE imaging was 0.913(95%confidence interval was0.878 and 0.948 respectively),the sensitivity,specificity were 81.1%and 87.0%respectively.Taking the submandibular glands'YM Emean was18.68 kPa as threshold,the area under the ROC curve of SWE imaging was 0.868(95%confidence interval was 0.823 and 0.914 respectively).3.The difference of Young's modulus among four groups was statistically significant(F=78.60,p<0.001).4.The Young's modulus increased with the damage of parotid function in SS groups.(r_s=0.83).Taking 18.10kPa,28.82kPa,38.38 kPa as threshold,the area under the ROC curve of Young's modulus was0.885,0.899,0.930 in diagnosis of mild?moderate and severe parotid function damage.the sensitivity,specificity were81.5%,80.0%;85.0%,81.5%;89.3%,84.7%respectively.Conclusion:1.The young's modulus Emean of salivary glands in patients with Sjogren syndrome has no relation to the side.2.SWE young's modulus have high value in the diagnosis of salivary gland lesions in SS patients.3.SWE young's modulus and scintigraphy have a good correlation in the evaluation of parotid function.It can indirectly evaluate the function of parotid gland,It is of high value in early evaluation of SS patients with parotid gland dysfunction.4.SWE provides a new method for clinical diagnosis of SS because of its advantages of non-invasive,simple,repeatability and high diagnostic value.