Sandrine Jousse-Joulin1, Vera Milic2, Malin V Jonsson3, Athena Plagou4, Elke Theander5, Nicoletta Luciano6, Pascale Rachele6, Chiara Baldini7, Hendrika Bootsma8, Arjan Vissink9, Alojzija Hocevar10, Salvatore De Vita11, Athanasios G Tzioufas4, Zarin Alavi12, Simon J Bowman13, Valerie Devauchelle-Pensec14. 1. Department of Rheumatology, La Cavale Blanche University Hospital, Department of Rheumatology-ERI 29, Brittany University, Brest, France. 2. Institute of Rheumatology, School of Medicine, University of Belgrade, Belgrade, Serbia. 3. Department of Clinical Dentistry, Section for Oral and Maxillofacial Radiology, University of Bergen, Bergen, Norway. 4. Department of Pathophysiology, School of Medicine, National University of Athens, Athens, Greece. 5. Department of Rheumatology, Skåne University Hospital, Malmö, Sweden. 6. Department of Diagnostic and Interventional Radiology. 7. Rheumatology Unit, University of Pisa, Pisa, Italy. 8. Department of Rheumatology and Clinical Immunology. 9. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. 10. Department of Rheumatology, University Medical Centre, Ljubljana, Slovenia. 11. Rheumatology Clinic, DSMB, Department of Medical and Biological Sciences, University Hospital 'Santa Maria della Misericordia', Udine, Italy. 12. INSERM, CIC 1412, Brest Medical University Hospital, Brest, France and. 13. New Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK. 14. Department of Rheumatology, La Cavale Blanche University Hospital, Department of Rheumatology-ERI 29, Brittany University, Brest, France, valerie.devauchelle-pensec@chu-brest.fr.
Abstract
OBJECTIVE: Ultrasonography (US) is a sensitive tool in the diagnosis of major salivary gland abnormalities in primary Sjögren's syndrome (pSS). The aim of this systematic review was to assess the metric properties of this technique. METHODS: PUBMED and EMBASE databases were searched. All publications between January 1988 and January 2013 were considered. Data were extracted from the articles meeting the inclusion criteria according to US definition of salivary gland scoring system and metric properties studied. The type and number of glands tested, study design and metric properties according to OMERACT filter (truth, discrimination, feasibility) were assessed. RESULTS: Of 167 publications identified initially with PUBMED and EMBASE, 31 met the inclusion criteria. The number of pSS patients varied among the studies from 16 to 140. The diagnosis of pSS was in line in most of the cases with the American-European Consensus Group (AECG) classification criteria for Sjögren's syndrome. The US examination was performed in suspected pSS only in studies in which the sensitivity ranged from 45.8 to 91.6% and specificity from 73 to 98.1%. There was heterogeneity in regard to the definition of US in B-mode and few studies used US in colour Doppler. Few studies reported reliability of US and sensitivity to change in pSS. CONCLUSION: US is a valuable tool for detecting salivary gland abnormalities in pSS. Its reliability has been poorly investigated and there is considerable variation in the definition of US abnormalities. Further studies are required to validate and standardize the US definition of salivary gland in pSS.
OBJECTIVE: Ultrasonography (US) is a sensitive tool in the diagnosis of major salivary gland abnormalities in primary Sjögren's syndrome (pSS). The aim of this systematic review was to assess the metric properties of this technique. METHODS: PUBMED and EMBASE databases were searched. All publications between January 1988 and January 2013 were considered. Data were extracted from the articles meeting the inclusion criteria according to US definition of salivary gland scoring system and metric properties studied. The type and number of glands tested, study design and metric properties according to OMERACT filter (truth, discrimination, feasibility) were assessed. RESULTS: Of 167 publications identified initially with PUBMED and EMBASE, 31 met the inclusion criteria. The number of pSS patients varied among the studies from 16 to 140. The diagnosis of pSS was in line in most of the cases with the American-European Consensus Group (AECG) classification criteria for Sjögren's syndrome. The US examination was performed in suspected pSS only in studies in which the sensitivity ranged from 45.8 to 91.6% and specificity from 73 to 98.1%. There was heterogeneity in regard to the definition of US in B-mode and few studies used US in colour Doppler. Few studies reported reliability of US and sensitivity to change in pSS. CONCLUSION: US is a valuable tool for detecting salivary gland abnormalities in pSS. Its reliability has been poorly investigated and there is considerable variation in the definition of US abnormalities. Further studies are required to validate and standardize the US definition of salivary gland in pSS.
Authors: Giuliana Maria Concetta La Paglia; Olga Sanchez-Pernaute; Alessia Alunno; Maria José Martínez-Becerra; Fredeswinda Romero-Bueno; Sheila Recuero; Pablo Eder Borges; Ignacio Mahillo-Fernández; Jesús Garrido; Roberto Gerli; Gabriel Herrero-Beaumont; Esperanza Naredo Journal: Clin Rheumatol Date: 2019-11-01 Impact factor: 2.980