Background Sjogren Syndrome (SS) affects mainly exocrine glands. The latest diagnostic criteria designed for clinical studies are also used as guidance in clinical practice [1].

Ultrasonography (US) demonstrates specificity and sensibility in parotid and submandibular gland evaluation (SG). Parameters considered are echogenicity, homogeneity and margins regularity [1,2,3]. To standardize the assessment of B mode US of SG, different semi-quantitative scores were proposed.

Objectives To apply and compare 9 US semi-quatitative scoring systems in B mode scanning of salivary glands in Sjogren Syndrome.

Methods A research using keywords “salivary glands”, “ultrasonograpy”, “Sjogren Syndrome”, “semi-quantitative score” in Medline/Pubmed was performed. There was a selection of most relevant articles. There were not considered relevant publications with impact factor <1. We performed the examination on SG in B mode US and applied these scores (De Vita, Niemela, Hocevar, Salaffi, Yukinori, Cornec,Theander) to our patients (primary and secondary SS).

Results Eighty four SG in patients diagnosed with primary and secondary (57.15%) SS were assessed. In the group of patients with SSA/SSB presence (85.7%), mean score was De Vita 1.78+/-1.21, Niemela 2.56+/-2.17, Hocevar and Wernicke 2.39+/-2.14, Salaffi 2.83+/-2.52, Yukinori 2.39+/-2.14, Milic 3.39+/-2.14, Cornec 1.78+/-1.215, Theander 1.28+/-0.752. Schirmer test and the need for using the artificial tears was correlated to SG alterations in scoring systems proposed by Niemela (r 0.465, p<0.05) and Salaffi ( r 0.496, p<0.02). All scoring systems were strongly correlated between them (r>0.8, p<0.01).

Conclusions Inhomogeneity of parenchyma was considered in all scoring systems. Others considered relevant glandular dimension and margins regularity [2,3.4]. There was no difference between the scoring systems. Xeroftalmia valided through Schirmer test is correlated to SG parenchymal alterations. Our data is an update about semi-quantitative scoring systems in US of SG in SS.

References

1. Vitali C, Bombardieri S, Jonsson R et al. Classification criteria for Sjögren's Syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. AnnRheum Dis 2002;61:554–8.

2. Makula E, Pokorny G, Palkό A.The place of magnetic resonance and ultrasonographic examinations of the parotid gland in the diagnosis and follow-up of primary Sjögren's syndrome. Rheumatology (Oxford). 2000;39(1):97–104.

3. Niemelä RK, Takalo R, Hakala M. Ultrasonography of salivary glands in primary Sjogren's syndrome. A comparison with magnetic resonance imaging and magnetic resonance sialography of parotid glands. Rheumatology (Oxford). 2004 Jul;43(7):875–9.

4. El Miedany YM, Ahmed I, El Gafaary M. Quantitative ultrasonography and magnetic resonance imaging of the parotid gland: can they replace the histopathologic studies in patients with Sjogren's syndrome? Joint Bone Spine.2004;71(1):29–38.

References

Disclosure of Interest None declared