Diagnostic Value Of Multimodal Ultrasound In Lacrimal Gland Lesions In Primary Sjogren’s Syndrome

Objective:The value of multimodal ultrasound parameters for the diagnosis of p SS lacrimal gland lesions was investigated using multimodal ultrasound to assess the two-dimensional ultrasound performance of the lacrimal gland,the values of lacrimal artery blood flow parameters,and the mean Young’s modulus values(Emean)of the lacrimal gland in patients with primary dry syndrome(p SS).Methods:46 patients with p SS and 50 healthy volunteers who were outpatients and inpatients in the Department of Rheumatology and Immunology of our hospital from September 2021 to September 2022 were selected,and two-dimensional ultrasound,Doppler ultrasound and Shear Wave Elastrography(SWE)were performed on all subjects to observe and compare differences of the echogenicity,circumference,area of the lacrimal gland,peak systolic flow velocity(PSV),end-diastolic flow velocity(EDV),resistance index(RI)and Emean of the lacrimal gland between the two groups;patients with p SS were divided into a group with ≤5 years of disease duration and a group with >5 years of disease duration according to the duration of disease,and differences in lacrimal gland echogenicity,circumference,area,lacrimal artery PSV,EDV,RI,and Emean values were compared between the two groups;subject work(ROC)curves were plotted.Results:1.38 cases(38/50,76.0%)in the healthy control group showed an internally homogeneous moderate to low substantial echogenicity in the lacrimal gland,while25 cases(25/46,54.3%)in the p SS group showed an internally heterogeneous echogenicity with small hypoechogenicity or a little striated hyperechogenicity,with statistically significant differences between the two echogenicity groups(P < 0.05);the differences in lacrimal gland circumference and area between and within the two groups There was no statistically significant difference in the circumference and area of the lacrimal gland between and within the two groups(P > 0.05);the sensitivity of the diagnosis of p SS by echogenicity of the lacrimal gland was 54.3% and the specificity was 76.0%.2.The differences in PSV,EDV and RI values between the left and right lacrimal arteries within the group of all subjects were not statistically significant(P >0.05);the differences in PSV and EDV of the lacrimal arteries between the p SS group and healthy controls were not statistically significant(P > 0.05)and the differences in RI values were statistically significant(P < 0.05);the area under the ROC curve(AUC)for the diagnosis of p SS with RI values was 0.723(95% confidence interval0.568,0.847),with a sensitivity of 52.63% and specificity of 96.00% for the diagnosis of p SS at an RI value of 0.69.3.The difference in Emean values measured by SWE of the right and left lacrimal glands within all subject groups was not statistically significant(P > 0.05);the difference in Emean values between the p SS group and healthy controls was statistically significant(P < 0.05);the AUC for the diagnosis of p SS with Emean values was 0.965(95% confidence interval 0.865,0.997),with a Emean value of At8.9 k Pa,the sensitivity for the diagnosis of p SS was 95.00% and the specificity was100%.4.The differences in lacrimal gland echogenicity,lacrimal gland circumference,area,lacrimal artery PSV,EDV,RI,and lacrimal gland Emean values between the p SS group with ≤5 years of disease and the two groups with >5 years of disease were not statistically significant(P >0.05).Conclusion:Two-dimensional ultrasound can observe the homogeneity of the lacrimal gland echogenicity,Doppler ultrasound can observe the lacrimal artery blood flow parameters,SWE can quantify the hardness of the lacrimal gland,and lacrimal gland echogenicity,increased RI,and increased Emean values can provide diagnostic aids in the diagnosis of p SS.