Description

Niemela et al used an ultrasonographic classification for changes in salivary glands associated with primary Sjogren's syndrome. This extends the grading scheme of Makula et al (see previous section) by the addition of a 4th grade. The authors are from Oulu University and Rheumatism Foundation Hospital (Heinola) in Finland.


 

Parameters:

(1) diameter of hypoechogenic areas in mm

(2) adipose degeneration (parenchymal atrophy with adipose tissue echogenicity)

 

Diameter of Hypoechogenic Areas

Adipose Degeneration

Parenchymal Inhomogeneity (PIH)

none

absent

Grade 0 (absent)

< 2 mm

absent

Grade 1 (mild)

2 to 6 mm

absent

Grade 2 (evident)

> 6 mm

absent

Grade 3 (gross)

NA

present

Grade 4

 

Other features seen on ultrasonography:

(1) hyperechoic bands

(2) cysts

 

Performance:

• Ultrasonography had a sensitivity of 78% and specificity of 94%.

• The most sensitive imaging modality is MR sialography (96%). MR imaging had a sensitivity only slightly better than US.

 


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