What is the best salivary gland ultrasonography scoring methods for the diagnosis of primary or secondary Sjögren's syndromes? - 02/03/19
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Abstract |
Objective |
To evaluate the performance of salivary gland ultrasonography for the diagnosis of primary and secondary Sjögren's syndromes (pSS and sSS).
Method |
Multicenter cross-sectional study on 97 patients with clinical sicca symptoms. The pSS (n = 22) met the American-European Consensus Group (AECG) classification criteria. The control patients (n = 36) with sicca symptoms did not fulfill the AECG criteria. Four scores were used to evaluate the 4 major salivary gland echostructure: the Salaffi score (0–16), Jousse-Joulin score (0–4), Hocevar score (0–48) and Milic score (0–12).
Results |
The medians of ultrasonographic (US) scores were higher in the pSS and sSS groups than in the control group (P < 0.001). The receiver-operating characteristic (ROC) curves and the positive likelihood ratio (LR+) of the four scores showed a good diagnostic performance for the US diagnosis of pSS and sSS. Respectively, for pSS and sSS, the AUC were 0.891 (95%CI 0.812–0.970) and 0.824 (95%CI 0.695–0.954) for Hocevar score, 0.885 (95%CI 0.804–0.965) and 0.808 (95%CI 0.673–0.943) for Milic score, 0.915 (95%CI 0.848–0.982) and 0.844 (95%CI 0.724–0.965) for Salaffi score, 0.897 (95%CI 0.821–0.973) and 0.851 (95%CI 0.735–0.968) for Jousse-Joulin score. This study showed an interesting inter-observer reproducibility (kappa = 0.714 ± 0.131) of the US evaluation with 85.7% agreement between reader to determine the pathological character of the salivary glands.
Conclusion |
Salivary gland US is a simple, non-invasive and performant imaging procedure for the diagnosis of pSS and sSS, with Salaffi, Milic and Jousse-Joulin scores.
Le texte complet de cet article est disponible en PDF.Keywords : Sjogren's syndrome, Salivary gland, Ultrasound
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Vol 86 - N° 2
P. 211-217 - mars 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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