Value of conventional ultrasound and shear wave elastography in assessing disease activity and prognosis in female patients with Sjögren's syndrome.

Abstract

This study aimed to assess the diagnostic value of labial salivary gland changes in female patients with Sjögren's syndrome (SS) having different European League Against Rheumatism (EULAR) Sjögren's Syndrome Disease Activity Index (ESSDAI) and serological markers using conventional ultrasound and shear wave elastography (SWE). A total of 82 female inpatients diagnosed with SS were retrospectively examined at the First Affiliated Hospital of Soochow University from July 2020 to December 2021. The patients were divided into two groups based on the ESSDAI score: remission group (ESSDAI <5) and active group (ESSDAI ≥5). The prognosis of patients was assessed using serological markers. The ultrasound examination of bilateral labial glands was performed in all patients to analyse the quantity and area of the largest single labial gland per unit detection range (Smax). The SWE of labial glands was performed in different groups. The Smax and quantity of labial glands on both sides were correlated with patient age in 82 female patients with SS. Emin, Emean and Emax of the remission group based on ESSDAI were significantly lower than the active group (p<0.001), and the areas under the receiver operating characteristic (ROC) curve for these three in diagnosing were 0.720, 0.728 and 0.734, respectively. The differences in Emean, Emin and Emax values of labial glands between the two groups of immunoglobulin G (IgG) <16g/L and IgG ≥16g/L were statistically significant (p<0.05), and the area under the ROC curve (AUC) for the three values were 0.825, 0.830, and 0.815, respectively. There were statistically significant differences (p<0.05) in Emin, Emean, and Emax of labial glands between the hypocomplementaemic and non-hypocomplementaemic groups, and the AUC for the three values were 0.840, 0.843, and 0.819, respectively. Conventional ultrasound and SWE of the labial gland can reflect the disease activity and prognosis of patients with SS, and more conveniently assess the progression in the patients and provide imaging evidence.