Diagnostic accuracy of parotid CT for identifying Sj?gren's syndrome

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• 作者：Zhipeng Sun ; Zuyan Zhang ; Kaiyuan Fu ; Yanping Zhao ; Denggao Liu ; Xuchen Ma
• 关键词：Sjö ; gren's syndrome ; Xerostomia ; Parotid gland ; Radiology ; Computed tomography
• 刊名：European Journal of Radiology
• 出版年：2012
• 出版时间：October, 2012
• 年：2012
• 卷：81
• 期：10
• 页码：2702-2709
• 全文大小：944 K

文摘

Purpose

To evaluate the diagnostic accuracy of computed tomography (CT) of the parotid gland for Sj?gren's syndrome in comparison with conventional X-ray sialography.

Methods

CT scans and X-ray sialography were performed in 34 patients with confirmed Sj?gren's syndrome and 22 symptomatic controls without the disease. CT data from 57 asymptomatic controls were included for quantitative analysis. The CT findings of heterogeneity, abnormal diffuse fat tissue deposition, diffuse punctate calcification, swelling or atrophy, nodularity or cystic changes of the parotid gland were analyzed by two independent blinded readers. The correlation between CT and X-ray sialography findings was evaluated. Diagnostic performance and receiver operating characteristics curves were calculated.

Results

On CT, heterogeneity of the parotid gland was seen in 30/31 (reader 1/reader 2) Sj?gren's syndrome patients by the two readers (sensitivity 88.2 % /91.2 % ; specificity 100 % /90.9 % ). Abnormal diffuse fat tissue deposition was seen in 28/28 SS patients by the readers (sensitivity 82.3 % /82.3 % ; specificity 100 % /90.9 % ). Diffuse punctate calcification was seen in 10/12 Sj?gren's syndrome patients (sensitivity 29.4 % /35.2 % ; specificity 100 % /100 % ). Stagings of CT findings correlate positively with sialography. The areas under the receiver operating characteristics curves were 0.887 (P = 0.000) and 0.908 (P = 0.000) for the maximum and standard deviation (SD) of the CT value.

Conclusions

Parotid CT is accurate and reliable in the diagnosis of Sj?gren's syndrome. Heterogeneity, abnormal diffuse fat tissue deposition, and diffuse punctate calcification are specific for Sj?gren's syndrome. CT attenuation analysis is helpful in diagnosis.