干燥综合征的腮腺MRI表现  

MRI features of the parotid gland in Sj?gren syndrome

作　　者：丁长伟[1] 郭启勇[1] 邢晓菲[1] 郭韵[2] 崔华东[2] 

机构地区：[1]中国医科大学附属盛京医院放射科,沈阳110004 [2]中国医科大学附属盛京医院风湿科,沈阳110004

出　　处：《中华放射学杂志》2014年第5期386-390,共5页Chinese Journal of Radiology

摘　　要：目的：探讨干燥综合征（ SS）的腮腺MRI表现特点。方法收集因口干于本院就诊的27例患者，根据SS国际分类诊断标准，分为SS组（21例）和非SS组（6例）。另外选取10名健康志愿者作为对照组。所有受试者均行常规腮腺MRI检查和双侧腮腺导管MR成像（ MRS）。观察T1 WI和T2 WI上信号强度的标准差，并进行脂肪信号分级和腮腺导管扩张程度分级。以临床诊断为金标准，评价常规MRI、MRS及二者联合应用对SS的诊断效能。采用单因素方差分析比较3组受试者腮腺信号强度标准差的差异，采用配对四格表χ2检验比较常规MRI和MRS诊断SS的差异，采用一致性检验比较SS组2种分级结果的一致性。结果对照组和非SS组受试者腮腺常规MRI信号均匀；SS组患者均为双侧腮腺病变，表现为腮腺信号不均匀，T1 WI和T2 WI上均见多发弥漫分布的高信号，在抑脂T2 WI上呈低信号；42个腮腺的脂肪信号分级，0级2个、1级10个、2级10个、3级6个、4级14个。 MRS上对照组和非SS组受试者均未见腮腺末梢导管扩张；SS组患者均为双侧腮腺病变，表现为弥漫性腮腺末梢导管扩张；42个腮腺的腮腺导管扩张程度分级，0级12个、1级8个、2级10个、3级5个、4级7个。 SS组、非SS组和对照组腮腺T1 WI 信号强度的标准差分别为124.1±30.0、81.8±27.6和86.3±35.0，T2 WI信号强度的标准差分别为115.1±35.2、69.8±23.5和80.1±31.4， SS组信号强度的标准差均高于非SS组和对照组，差异有统计学意义（ F值分别为13.780和13.301， P值均＜0.01）；而非SS组和对照组腮腺信号强度标准差差异无统计学意义（P＞0.05）。21例SS患者的42个腮腺中，常规MRI和MRS分别检出病变腮腺40和30个，均无假阳性结果，差异有统计学意义（χ2＝13.04，P＝0.013），而2种方法联合应用检出了全部42个病变腺体。脂肪信号分级和腮腺导管扩张程度分级方法诊断Objective To investigate MR imaging features of parotid gland in Sj？gren′s syndrome （ SS）.Methods Twenty-seven cases of xerostomia patients were collected and divided into SS group （ n=21） and non-SS group （n=6） according to the international classification （diagnosis） criteria for SS.Ten healthy volunteers were recruited as the control group.All the subjects underwent conventional MRI of parotid gland and MR sialography （ MRS）.Standard deviation of T 1 WI and T2 WI signal intensity among 3 groups was observed, meanwhile, grading was made according to parotid glands , fat signal and parotid duct expansion degree respectively.With clinical diagnosis as the gold standard , diagnostic value of conventional MRI , MRS and their combination used in SS was compared.One-way ANOVA was used in comparison of standard deviation of parotid gland′s signal intensity among 3 groups , and Chi-square test was applied in comparison of conventional MRI and MRS diagnostic value.Moreover , Kappa value was calculated to assess the consistency of two grading results in SS.Results Signal intensity of parotid glands in control group and non-SS group was homogeneous.However , bilaterally diffused and heterogeneous high signal intensity on both T1WI and T2WI was found in SS patients, which was depressed on T2WI fat suppression sequences.Forty-two parotid glands were graded by fat signal：Grade 0 （n=2 glands）, Grade 1＆amp;nbsp;（n=10）, Grade 2 （n=10）, Grade 3 （n=6） and Grade 4 （n=14）.Parotid peripheral ducts of control group and non-SS group were unexpanded , while bilaterally expanded parotid peripheral ducts were shown in SS patients.The grading of 42 parotid glands by expansion degree of parotid duct , Grade 0 was rated in 12, Grade 1 in 8, Grade 2 in 10, Grade 3 in 5, and Grade 4 in 7.Standard deviation of T1WI signal intensity of parotid glands among SS group , non-SS group and control group were 124.1 ±30.0, 81.8 ±27.6, and 86.3 ±35.0 respectively;and standard deviation of T 2 WI signa

关 键 词：干燥综合征 腮腺 磁共振成像 涎腺造影术 

分 类 号：R593.2[医药卫生—内科学] R445.2[医药卫生—临床医学]