THU0376 Characteristics of primary sjÖgren’s syndrome patients with morphological changes of the parotid glands in mr imaging
Authors: S. Zhao, H. Zhang, C. Chu, X. Feng, L. Sun
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Primary Sjögren's syndrome (pSS) is a chronic autoimmune disease characterised by injury of exocrine glands, and a considerable proportion of pSS patients develop extraglandular involvement. The parotid glands are the most frequently involved glands in pSS. Conventional parotid examinations, such as X-Ray sialography and 99mTechnetium ([99mTc]) pertechnetate scintigraphy, played an important role in the diagnosis of pSS. However, X-Ray sialography only shows the abnormality of parotid ductal system and there is exposure to radionuclides with 99mTechnetium. Both examinations are invasive, while MR imaging is noninvasive, radiation-free, and sensitive to the morphological and signal changes of the parotid glands. MR sialography could be used to evaluate the parotid ductal system without the need for a contrast agent. But the clinical application value of parotid grand MR imaging in pSS patients has not been verified. <h3>Objectives</h3> The purpose of this study was to investigate the morphological changes of the parotid glands in MR imaging in patients with pSS and the correlations between morphological changes and the clinical manifestations. <h3>Methods</h3> Ninty-nine pSS patients who underwent parotid 3.0 Tesla MR imaging (T1, T2 and T2 STIR) were enrolled in this study. The morphological changes of the parotid glands (grades 0–3) and ducts (grades 0–4) were rated according to our previous studies.<sup><sup>1</sup></sup> Patients were divided into normal parotid MR group (both glands grade and ducts grade were 0) and abnormal parotid MR group. The correlations between morphological changes of the parotid glands and clinical or serological characteristics were analysed by chi-square test. <h3>Results</h3> There were 93 females (93.9%) and 6 males (6.1%) in this study. The mean age and median disease duration were 47.4 years and 24 months. There were 50 (50.5%) pSS patients in parotid grand grade 0, 27 (27.3%) in grade 1, 15 (15.2%) in grade 2 and 6 (6.1%) in grade 3 (Fig 1A), and there were 53 (53.5%) pSS patients in parotid duct grade 0, 15 (15.2%) in grade 1, 17 (17.2%) in grade 2, 4 (4.0%) in grade 3, and 10 (10.1%) in grade 4 (Fig 1B). We found that patients in abnormal parotid MR group presented lower positive rates of myasthenia and higher positive rates of xerostomia, Schimer's test, serum anti-SSA antibodies, anti-Ro-52 antibodies, antinuclear antibodies (ANA), rheumatoid factor (RF), plasma globulin, immunoglobulin G (IgG), and Hashimoto thyroiditis (p&lt;0.05). But no significant difference was observed between two groups in the incidence of salivary gland enlargement, articular involvement, dermatological involvement, interstitial lung disease, tubulointerstitial nephritis and primary biliary cirrhosis. <h3>Conclusions</h3> The results indicated that parotid MR imaging is a noninvasive, radiation-free examination with a potential role in diagnosing pSS. pSS patients with morphological changes of the parotid glands in MR imaging were more likely to have xerostomia, hyperglobulinemia and thyroid involvement. <h3>Reference</h3> [1] Chen Chu, Nan Zhou, Huayong Zhang, et al. Added Value of Parotid R2* Values for Evaluation of Sjögren Syndrome: A Preliminary Study. J Comput Assist Tomogr2017;41(4):547–552. <h3>Disclosure of Interest</h3> None declared