OP0236 Ultrasonography of major salivary glands in primary sjÖgren’s syndrome – correlation with glandular function and minor gland inflammation
Authors: D. Hammenfors, R. Jonsson, J.G. Brun, M.V. Jonsson
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Ultrasound (US) represents a non-invasive imaging method of the major salivary glands that may serve as a supplement to minor salivary gland biopsy. Minor salivary gland biopsy is part of the diagnostic process for primary Sjögren's syndrome (pSS), but is not suitable for repeated follow-up. <h3>Objectives</h3> To investigate if parotid and submandibular gland ultrasonography findings may contribute to pSS diagnosis and in the assessment of glandular function and disease activity. <h3>Methods</h3> Ultrasound of the parotid and submandibular glands was performed with a GE Logiq E9 using a linear transducer with 6-15MHz. The parotid glands were evaluated in a longitudinal and cross-sectional plane and the submandibular glands in a longitudinal plane. Glandular homogeneity and presence of hypoechogenic areas was evaluated and scored (0-3) according to Hocevar et al 2005 (1). Scores 0-1 were considered "normal" and scores 2-3 "pathological". Salivary gland functional capacity was evaluated by unstimulated and stimulated sialometry of whole saliva, in ml/15 minutes and ml/5 minutes, respectively (n=21). Ultrasound scores were compared to sialometric findings and minor salivary gland focus score where such data was available. <h3>Results</h3> Results: Ultrasound was performed in 20 patients, with scores ranging 0-1 (n=10) and 2-3 (n=10). Mean unstimulated and stimulated saliva were 1.1 ml/15 min and 3.3 ml/5 min, respectively, and levels correlated (p&lt;0.001, r=0.726, n=21). Ultrasound scores correlated with unstimulated (p&lt;0.001, r=0.721, n=20) and stimulated saliva (p&lt;0.05, r=0.546, n=20). Mean unstimulated and stimulated saliva levels were higher in patients with normal ultrasound findings compared to pathological (p&lt;0.05). 10/14 patients with unstimulated saliva ≤1.5ml/15 min had pathological ultrasound changes compared to 0/6 with normal unstimulated saliva (p&lt;0.01). 9/12 with stimulated saliva ≤3.5ml/5 min had pathological ultrasound compared to 1/8 with normal stimulated saliva (p&lt;0.01). Focus score was available in 17/21 patients (mean 2.1, range 0-7), and was ≥1 in 14/17 patients. Focus score correlated with ultrasound score (p&lt;0.05, r=0.516, n=16) and mean focus score was 3.3 in patients with ultrasound pathology and 1.2 in patients with normal ultrasound (p&lt;0.05). <h3>Conclusions</h3> In a small cohort of patients with pSS findings from non-invasive imaging method ultrasound correlate with glandular function and minor salivary gland inflammation. Ultrasound of major salivary glands may become a useful tool in both diagnostics and follow-up of patients with pSS. <h3>References</h3> Hocevar A, Ambrozic A, Rozman B, Kveder T, Tomsic M. Ultrasonographic changes of major salivary glands in primary Sjögren's syndrome. Diagnostic value of a novel scoring system. Rheumatology (Oxford). 2005 Jun;44(6):768-72. <h3>Disclosure of Interest</h3> None Declared