LAUSR

Background Sjögren’s syndrome involves multiple organs, especially the lacrimal and salivary glands. Salivary gland ultrasonography (SGUS) is quick and easily accessible, which provides visibility of salivary glands. Currently, there were several scoring systems for SGUS. Acuity for different image parameters remained unclear, and these parameters including heterogeneity of glands, clearance of posterior border, size of glands, fibrosis bands and size of vacuoles in the glands. Each gland would be scored through these parameters which may rank from 0 to 3 or 0 to 4. The weight of different parameters have not been clarified. Objectives To evaluate the effectiveness of different image parameters of SGUS in evaluation Sjögren’s syndrome. Methods Total SGUS with 56 patients were retrospectively evaluated, who also underwent minor salivary gland biopsy. SGUS was conducted by a 10MHz-13MHz linear probe at both parotid and submandibular glands. Each gland was scored from 0 to 4 according to the scoring scale proposed previously. The total maximum score was 16. Heterogeneous structure, fibrosis band and size of vacuoles were evaluated for each gland. Minor salivary gland biopsy was evaluated with Chisholm-Mason grade, ranging from 1-4. Results The distribution of minor salivary gland biopsy was grade 1 (28.6%), grade 2 (14.3%), grade 3 (19.6%), and grade 4 (37.5%). The average SGUS score was 6.00 for grade 1, 6.38 for grade 2, 7.00 for grade 3 and 10.00 for grade 4 (p=0.019). Evaluation different image parameters for each gland, heterogeneous structure and fibrosis bands revealed significant in linear regression of parotid gland score (heterogeneous structure p=0.043 for left side, p=0.025 for right side; fibrosis bands p<0.001 for both sides) but size of vacuoles did not reveal significant. Fibrosis bands and size of vacuoles revealed significant in the linear regression model of submandibular glands (both <0.001 in both sides). Final pathology grade correlated with fibrosis bands of left side parotid gland (p=0.006), fibrosis bands of both sides of submandibular glands (p=0.006 for left side, p=0.001 for right side), and size of vacuoles among submandibular glands (p=0.003 for left side, p=0.012 for right side). In regarding to the different image parameters, the biopsy result correlated well with total summation of SGUS (p=0.004). Conclusion Different image parameters had different significance for representing the gland conditions. For parotid glands, fibrosis bands and heterogeneous structure were main parameters. For submandibular glands, fibrosis bands and size of vacuoles accounted for the change of glands. SGUS correlated with final pathology result. References [1] Jousse-Joulin S, et al. Rheumatology (Oxford). 2016;55:789-800. [2] Takagi Y, et al. Ann Rheum Dis2010;69:1321-4. [3] Seror R, et al. Ann Rheum Dis2011;70:968-72. Disclosure of Interests None declared