Abstract
Sjögren’s syndrome (SS) is characterized by hypofunction of the salivary and lacrimal glands. The salivary function is largely dependent upon the blood supply in the glands. However, the diseased states of the gland perfusion are not well understood. The arterial spin labeling (ASL) technique allows noninvasive quantitative assessment of tissue perfusion without the need for contrast agent. Here, we prospectively compared the perfusion properties of the parotid glands between patients with SS and those with healthy glands using ASL MR imaging. We analyzed salivary blood flow (SBF) kinetics of 22 healthy parotid glands from 11 volunteers and 28 parotid glands from 14 SS patients using 3T pseudo-continuous ASL imaging. SBF was determined in resting state (base SBF) and at 3 sequential segments after gustatory stimulation. SBF kinetic profiles were characterized by base SBF level, increment ratio at the SBF peak, and the differences in segments where the peak appeared (SBF types). Base SBFs of the SS glands were significantly higher than those of healthy glands (59.2 ± 22.8 vs. 46.3 ± 9.0 mL/min/100 g, p = 0.01). SBF kinetic profiles of the SS glands also exhibited significantly later SBF peaks (p < 0.001) and higher SBF increment ratios (74 ± 49% vs. 47 ± 39%, p = 0.04) than the healthy glands. The best SBF criterion (= 51.2 mL/min/100 mg) differentiated between control subjects and SS patients with 71% sensitivity and 82% specificity. Taken together, these results showed that the SS parotid glands were mostly hyperemic and the SS gland responses to gustatory stimulation were stronger and more prolonged than those of the healthy glands. The ASL may be a promising technique for assessing the diseased salivary gland vascularization of SS patients.
Highlights
Sjögren’s syndrome (SS) is a multisystem autoimmune disorder symptomatically and characterized by hypofunction of the salivary and lacrimal glands [1]
We selected 16 patients from those who presented with sicca symptoms between April 2012 and August 2013, were diagnosed with SS according to the American-European Consensus Group (AECG) criteria (n = 14) or based on the Japanese criteria (n = 2) [1, 9], and agreed to participate in the study and provided written informed consent
The salivary blood flow (SBF) peaks of SS glands appeared in significantly later segments after gustatory stimulation than those of healthy glands (p < 0.001) (Fig 2A–2E, Tables 2 and 3)
Summary
Sjögren’s syndrome (SS) is a multisystem autoimmune disorder symptomatically and characterized by hypofunction of the salivary and lacrimal glands [1]. The salivary glands receive an innervation from cholinergic parasympathetic and sympathetic nerves to evoke the secretion of saliva by acinar cells and the release of stored proteins from acinar and duct cells. ASL of Parotid Glands in Patients with SS other hand, the fluid component of saliva is supplied by a dense network of blood vessels, which receive innervation from parasympathetic and sympathetic nerves. It can be expected that the blood supply (perfusion) of the salivary glands is disordered in patients with SS. The diseased states of the gland perfusion in patients with SS are not well understood
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
