Comparative Study On Parotid CT Scan,CT Sialography And X-Ray Sialography In Sjogren's Syndrome

Objective:This study use the parotid CT scan,CT sialography and contrast with the X-ray sialography for the comparative study,to analyse SS in the parotid CT scan and sialography imaging features,provide the basis of clinical diagnosis and the differential diagnosis,in order to improve the diagnostic accuracy in Sjogren's syndrome.Methods:One patient group was 97 suspecte cases of affected by Sjogren'Syndrome,The control group was 30 cases of healthy adults.First,two group were examined by GE Light speed MSCT scan,the patient group examined by Parotid CT sialography and X-ray sialography,one of 77 cases of patient group did unilateral parotid X-ray sialography and CT sialography,and the other 20 cases did bilateral parotid CT sialography.Parotid CT imaging will be the adoption of three-dimensional image reconstruction technique,using multi-planar reconstruction(MPR),maximum intensity projection(MIP) and volume rendering(VR) technology reconstruction;measuring parotid three level density(CT value);Analysed the characteristics of the image in the parotid gland X-ray sialography,CT scan and sialography..the results of the study contrast with labial gland biopsy and clinical diagnostic criteria for research and statistical analysis.Results:1.In this study collected 97 cases,with reference to the International Classification of 2002,SS(diagnostic) criteria for diagnosis,diagnosed as one of 80 cases of Sjogren's syndrome patients.2.30 cases of The control group in parotid CT scan showed bilateral symmetry of uniform density shadow,its density lower than the surrounding muscle density,22 cases like fat density.Confirmed SS of group,38 cases of bilateral parotid gland was non-uniform increase in the soft tissue density;34 cases of bilateral parotid parenchymal showed coulds nodular of high-density,nodular space showed clearly,eight cases showed both sides of low-density like fat. both sides of the parotid gland CT value mean in the patient group was not difference statistically significant,suggesting that the parotid gland in Sjogren's syndrome with bilateral changes in the density of the same.But 10%of the parotid gland in Sjogren's syndrome patients with normal CT density line,we should not alone the gland CT high-density to diagnose SS.3.68 Cases of group X-ray sialography for the diagnosis of Sjogren's syndrome,56 cases showed the peripheral duct expansing vary degrees,the lead duct and branch duct not expaned;12 cases of peripheral duct and branches ducts reduced and the expansion,also as led ducts;three cases only showed the led ducts image expansion,branch ducts and peripheral ducts are not inaging.4.21 case diagnosed as normal in CT sialography showed normal gland parotid gland show-led axial tube,see the substance of the parotid gland was small contrast agent,or strip-like imaging,imaging light,distributed evenly. Reconstructed image at all branches of the parotid gland ducts see a clear image, the ducts was no expansion.Diagnosed 76 cases of patients with Sjogren's syndrome manifested as image layers axial CT clearly shows the parotid gland lead pipes,the substance of the parotid gland can be seen filling diffuse contrast agent,imaging thick,uneven.Image reconstruction,61 cases of parotid gland ducts leading edge smooth,the parotid gland led ducts and peripheral branch duct expansion were to varying degrees;one of 13 cases of parotid gland see peripheral ducts fusion was shaped soft tissue mass on VR images.And 15 cases of peripheral duct dilatation,also the expansion of led ducts.5.Parotid CT sialography deal with MPR,MIP,VR three types of technology,can better show the parotid duct and its branches duct,and no interference with bone and soft tissue.More than three-and branch ducts to shows the best of MIP(P＜0.05).6.CT sialography with X-ray sialography for diagnosis of Sjogren's syndrome comparative analysis(P＜0.05),suggestde that the overall detection Sjogren's syndrome rate of CT sialography was higher than X-ray sialography.7.X-ray sialography,CT sialography and the labial gland biopsy diagnosis of Sjogren's syndrome,one of CT sialography in the sensitivity, specificity,Were 90%,76.5%;and the clinical diagnostic criteria and have good consistency(Kappa value = 0.61＞0.4).8.Both sides of the parotid gland in Sjogren's syndrome patients are involved,there is a better consistency,only the line side of imaging,can achieve diagnostic purposes.Conclusion:Parotid CT scan and CT sialography can be used as Sjogren's syndrome an important diagnostic method,the diagnosis of Sjogren's syndrome sensitivity and specificity than the parotid high X-ray sialography,and diagnostic criteria and clinical classification of high consistency,is to diagnose Sjogren's syndrome more reliable means of imaging diagnosis.