干燥综合征下唇唾液腺MRI特征初步探索  

Preliminary study on MRI features of the lower lip salivary glands in Sjögren's syndrome

作　　者：梁云平 王苇[1] 瞿航 顾越 任昊麟 赵义[1] LIANG Yunping;WANG Wei;QU Hang;GU Yue;REN Haolin;ZHAO Yi(Department of Medical Imaging,Affiliated Hospital of Yangzhou University,Yangzhou 225000,China)

机构地区：[1]扬州大学附属医院医学影像科,扬州225000

出　　处：《磁共振成像》2024年第5期75-79,共5页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的探讨干燥综合征(Sjögren’s syndrome,SS)下唇唾液腺MRI特征及其诊断效能。材料与方法回顾性分析232例临床可疑SS患者的临床及下唇唾液腺MRI检查资料,按2016年美国风湿病学会/欧洲抗风湿病联盟共同制订的SS分类标准分为SS组(155例)与非干燥综合征(non-Sjögren’s syndrome,NS)组(77例)。观察下唇唾液腺T1WI、T2WI-非对称回波的最小二乘估算法迭代水脂分离(iterative decomposition of water and fat with echo asymmetric and least-squares estimation,IDEAL)水相影像特征(腺体体积、脂肪含量、信号特点)。基于T2WI-IDEAL水相应用ITK-SNAP软件测量、计算下唇唾液腺体积、信号强度的均值和标准差,并行单因素和多因素分析,通过二元logistic回归建立多因素联合预测模型,应用受试者工作特征(receiver operating characteristic,ROC)曲线评价独立影响因素及联合预测模型对SS的诊断效能。结果SS组与NS组分别有48例、12例患者下唇唾液腺MRI表现为腺体萎缩伴腺体间脂肪组织增多,T2WI-IDEAL水相信号不均匀减低,组间差异有统计学意义(χ^(2)=5.316,P=0.023)。下唇唾液腺体积、信号强度标准差的组间差异有统计学意义(Z=-3.260、-2.803;P=0.001、0.005),是SS的独立影响因素(OR=0.999、1.014;P=0.001、0.003),预测SS的曲线下面积(area under the curve,AUC)分别为0.629[95%置信区间(confidence internal,CI):0.553~0.704]、0.613(95%CI:0.534~0.692),两者联合预测模型的AUC值为0.682(95%CI:0.608~0.756)。结论SS下唇唾液腺MRI特征为腺体萎缩和信号不均,根据唇腺体积及信号强度标准差预测SS有一定诊断价值。Objective:To investigate MRI features and diagnostic efficacy of the lower lip salivary glands in Sjögren's syndrome(SS).Materials and Methods:The clinical and lower lip salivary glands MRI data of 232 patients with clinically suspected SS were retrospectively analyzed and divided into the SS group(155 patients)and the non-Sjögren's syndrome(NS)group(77 patients)according to the classification criteria for SS jointly developed by the American College of Rheumatology/European League Against Rheumatism in 2016.The lower lip salivary glands'T1WI and T2WI-iterative decomposition of water and fat with echo asymmetric and least-squares estimation(IDEAL)water-phase imaging features(glands volume,fat content,signal characteristics)were observed.Based on the T2WI-IDEAL water-phase sequence,ITK-SNAP software was used to measure and calculate the volume of the lower lip salivary glands,the mean and standard deviation of signal intensity,and univariate and multivariate analyses were performed,and the multi-factor joint prediction model was established by binary logistic regression.The diagnostic efficacy of independent influencing factors and combined prediction model on SS was evaluated by the receiver operating characteristic(ROC)curve.Results:MRI of the lower lip salivary glands in 48 and 12 patients in the SS and NS groups,respectively,showed glandular atrophy with increased inter-glandular fatty tissue,and the T2WI-IDEAL water-phase signal was unevenly reduced,with a statistically significant difference between the groups(χ^(2)=5.316,P=0.023).The lower lip salivary glands volume and signal intensity standard deviation had statistically significant intergroup differences(Z=−3.260,−2.803;P=0.001,0.005),were independent influences on SS(OR=0.999,1.014;P=0.001,0.003),and the areas under the curve(AUCs)of predicted SS were 0.629[95%confidence internal(CI):0.553-0.704]and 0.613(95%CI:0.534-0.692),respectively,the AUC value of the combined prediction model of the two features was 0.682(95%CI:0.608-0.756).Conclusions:The

关 键 词：唇腺 唾液腺 萎缩 干燥综合征 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R392.3[医药卫生—诊断学]