AB1068 Ultrasound of salivary glands in sjogren's syndrome- which semi-quantitative scoring system is the best?
Authors: VC Iorgoveanu, V Bojinca, V Vlad, D Mazilu, I Saulescu, L Groseanu, D Opris, A Balanescu, C Constantinescu, D Predeteanu, R Ionescu
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> 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. <h3>Objectives</h3> To apply and compare 9 US semi-quatitative scoring systems in B mode scanning of salivary glands in Sjogren Syndrome. <h3>Methods</h3> 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 &lt;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). <h3>Results</h3> 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&lt;0.05) and Salaffi ( r 0.496, p&lt;0.02). All scoring systems were strongly correlated between them (r&gt;0.8, p&lt;0.01). <h3>Conclusions</h3> 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. <h3>References</h3> Vitali C, Bombardieri S, Jonsson R et al. Classification criteria for Sjögren9s Syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. AnnRheum Dis 2002;61:554–8. 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 Sjögren9s syndrome. Rheumatology (Oxford). 2000;39(1):97–104. Niemelä RK, Takalo R, Hakala M. Ultrasonography of salivary glands in primary Sjogren9s syndrome. A comparison with magnetic resonance imaging and magnetic resonance sialography of parotid glands. Rheumatology (Oxford). 2004 Jul;43(7):875–9. 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 Sjogren9s syndrome? Joint Bone Spine.2004;71(1):29–38. <h3>Disclosure of Interest</h3> None declared