超声弹性成像在干燥综合征唾液腺病变中的应用价值

doi:10.19439/j.sjos.2018.01.017

摘要/Abstract

摘要： 目的: 探讨超声弹性成像技术中应变率比值法（SR）和声辐射力脉冲成像法（ARFI）在干燥综合征（SS）唾液腺病变诊断中的应用价值。方法: 收集 2017年1月—2017年7月上海交通大学医学院附属第九人民医院口腔外科门诊确诊的干燥综合征患者36例,健康对照病例25例。对双侧腮腺及下颌下腺进行SR及ARFI检查,获得双侧腮腺及下颌下腺的SR和剪切波速度（SWV）。比较同一组内腮腺、下颌下腺左侧与右侧之间以及不同组间同侧腮腺、下颌下腺 SR和SWV 的差异。采用SPSS 22.0软件包对数据进行统计学分析。结果: ①无论SS组还是健康对照组,左、右侧腮腺及下颌下腺之间SR值和SWV值差异均无显著性（P>0.05）;组间双侧腮腺、下颌下腺SR值差异均有显著性（P<0.05）;组间腮腺、下颌下腺SWV值差异均有显著性（P<0.05）。②以0.8962为截断值,采用SR检测腮腺、诊断SS的敏感度为77.8%,特异度为88.0%,曲线下面积达0.844;以0.8987为截断值,采用SR检测下颌下腺、诊断SS的敏感度为47.22%,特异度为84.0%,曲线下面积达0.652。③以1.6288为截断值,采用ARFI技术检测腮腺、诊断SS的敏感度为91.7%,特异度为88.0%,曲线下面积达0.943;以1.8788为截断值,采用ARFI技术检测下颌下腺、诊断SS的敏感度为44.4%,特异度为96.0%,曲线下面积0.614。结论: 超声弹性成像技术SR及ARFI可以提供腮腺及下颌下腺SR及SWV值,定量分析SS患者的腺体硬度,在临床诊断干燥综合征中有很好的应用价值。

关键词: 干燥综合征, 腮腺, 下颌下腺, 应变率比值法, 声辐射力脉冲成像法

Abstract: PURPOSE: To evaluate the value of strain rate ratio (SR) and acoustic radiation force impulse (ARFI) imaging in the diagnosis of salivary glands lesions in patients with Sjögren's syndrome (SS). METHODS: Thirty-six outpatients with SS in the Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2017 to July 2017 were collected. All patients were diagnosed as SS according to American-European Consensus Group criteria of 2002. 25 healthy controls were chosen as control. The bilateral parotid gland and submandibular gland were examined by strain rate ratio and ARFI imaging, and the SR and shear wave velocity (SWV) value were obtained. The differences in SR or SWV values between the left and right sides of the parotid gland or submandibular gland and between SS group and healthy control group were analyzed using SPSS 22.0 software package. RESULTS: There was no significant difference in SR and SWV value between left and right parotid gland and submandibular gland in the SS group and the healthy control group (P>0.05). There were significant differences in SR values between bilateral parotid gland and submandibular gland (P<0.05).There was significant difference in SWV values between the two groups (P<0.05). With 0.8962 as the cutoff value, the sensitivity of SS diagnosis in the parotid gland was 77.8% by using SR, the specificity was 88.0% and the area under the curve was 0.844. With 0.8987 as the cutoff value, the sensitivity of SS diagnosis in the submandibular gland was 47.22%,the specificity was 84.0% and the area under the curve was 0.652. By using ARFI technique, the sensitivity of SS diagnosis in the parotid gland was 91.7%, the specificity was 88.0%, and the area under the curve was 0.943, when the cutoff value was 1.6288. With 1.8788 as the cutoff value, the sensitivity of SS diagnosis in the submandibular gland was 44.4%, the specificity was 96.0%, and the area under the curve was 0.614. CONCLUSIONS: SR and ARFI imaging method can provide SR and SWV value of salivary gland to quantify the hardness of salivary glands in SS, which has great value in diagnosis of SS.

Key words: Sj?gren's syndrome, Parotid gland, Submandibular gland, Ultrasonic elastic strain rate ratio method, Acoustic radiation force impulse

中图分类号:

R445.1

张蔚蒨, 龚霞, 熊屏. 超声弹性成像在干燥综合征唾液腺病变中的应用价值[J]. 上海口腔医学, 2018, 27(1): 73-78.

ZHANG Wei-qian, GONG Xia, XIONG Ping. The value of ultrasonic elastography in diagnosis of salivary gland lesions in patients with Sjögren's syndrome[J]. Shanghai Journal of Stomatology, 2018, 27(1): 73-78.

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