Superb Microvascular Imaging Ultrasonography of Lacrimal Gland in Patients With Sjögren Syndrome
Condition: Inflammation; Sjogren's Syndrome; Gland; Inflammation
MeSH terms: Sjogren's Syndrome; Syndrome; Inflammation
Study type: Observational

Summary: 
      A prospective study will be conducted to evaluate inflammatory activity in lacrimal glands
      due to Sjögren's syndrome on Superb Microvascular Imaging (SMI), gray scale ultrasound (US),
      color Doppler US and Power Doppler US.
    

Detailed description: 
      In the disease activity index recommended by EULAR, the European Rheumatology Association, to
      evaluate the disease activity of patients with Sjögren's syndrome, it is recommended to
      measure the swelling in the gland by performing a clinical examination for glandular
      activity. However, it is not practical to measure the size of these glands due to their
      location.

      In studies in which lacrimal glands were evaluated by ultrasonographic methods, parameters
      such as gland size measurement, gland heterogeneity and Doppler activity were reported to be
      very successful in differentiating patients from healthy controls.

      Determining the presence and characteristics of vascular flow is an important part of
      ultrasonographic examinations. However, small vessels and low velocities are not always
      possible to detect with conventional color and power Doppler ultrasound. Sonographic
      examination will be inconclusive, especially if the presence of vascular flow or activity
      needs to be addressed as a basis for diagnosis and follow-up. Superb Microvascular Imaging
      (SMI) is a new vascular imaging mode that provides low speed and visualization of
      microvascular flow. SMI uses an algorithm that can suppress parasitic reverberations to
      extract flow signals and displays this information as a color overlay image or a
      monochromatic or color flow map.There are studies that report that Superb Microvascular
      Imaging (SMI), a new and up-to-date Ultrasonography technology, is more sensitive in
      detecting the activity of Rheumatic diseases. In this respect, there are no studies
      evaluating the inflammatory activity of lacrimal glands with SMI method.

      Therefore, a prospective study will be conducted to evaluate the inflammation detecting
      performance of SMI, gray scale US, color Doppler US and Power Doppler US. The null hypothesis
      that there is no difference between Doppler US and SMI methods in the detection of increased
      inflammatory activity in Sjögren's syndrome patients.
    

Intervention name(s): Superb Microvascular Imaging (SMI) (Toshiba)
Intervention type(s): Device
Intervention description(s): To determine whether SMI has diagnostic value for detecting the inflammatory state in the lacrimal glands in Sjögren's syndrome and whether it has any superiority compared to Power Doppler and Color Doppler modalities.
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        -  Patients who diagnosed as Sjögren's syndrome as the first group.

          -  Healthy participants as the second group
      
Keywords: superb microvascular imaging; microvascularization; Sjogren's syndrome; disease activitiy