Hocevar et al developed a scoring system for ultrasonographic changes in the major salivary glands seen in patients with primary Sjogren's syndrome. The authors are from University Vodnikova, General Hospital Slovenj Gradec, and the Community Health Centre of Ljubljana in Slovenia.
Ultrasound machine: 5-12 MHz linear array transducer
Glands examined:
(1) left parotid
(2) left submaxillary
(3) right parotid
(4) right submaxillary
Parameters:
(1) parenchymal echogenicity
(2) homogeneity
(3) hypoechoic areas
(4) hyperechoic areas
(5) delineation of salivary glands from surrounding tissues
|
Parameter |
Finding |
Points |
|
parenchymal echogenicity |
comparable to thyroid gland |
0 |
|
|
less than thyroid gland |
1 |
|
homogeneity |
homogeneous (no inhomogeneity) |
0 |
|
|
mild inhomogeneity |
1 |
|
|
evident (moderate) inhomogeneity |
2 |
|
|
grossly inhomogeneity |
3 |
|
hypoechoic areas |
none |
0 |
|
|
few and scattered |
1 |
|
|
several |
2 |
|
|
numerous |
3 |
|
hyperechoic areas in submandibular glands |
absent |
0 |
|
|
present |
1 |
|
hyperechoic areas in parotid glands |
none |
0 |
|
|
few and scattered |
1 |
|
|
several |
2 |
|
|
numerous |
3 |
|
delineation from surrounding tissue |
well-defined borders |
0 |
|
|
slightly less defined borders |
1 |
|
|
ill-defined borders |
2 |
|
|
blurred borders |
3 |
subscore for each submaxillary gland =
= SUM(points for all 5 parameters)
subscore for each parotid gland =
= SUM(points for all 5 parameters)
total score =
= SUM(points for all 4 salivary glands)
Interpretation:
• minimum subscore or score: 0
• maximum subscore for submaxillary gland: 11
• maximum subscore for parotid gland: 13
• maximum total score: 48 (according to the paper)
Performance:
• The sensitivity was 59% and specificity 99%.
• There was good (0.90) inter-observer agreement.
Purpose: To evaluate the major salivary glands from a patient with primary Sjogren's syndrome using ultrasonography as reported by Hocevar et al.
Specialty: Immunology/Rheumatology
Objective: imaging studies, severity, prognosis, stage
ICD-10: M35.0,
