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Contribution of salivary gland ultrasonography to the diagnosis of Sjögren's syndrome: toward new diagnostic criteria?

OBJECTIVETo determine the accuracy of salivary gland ultrasonography (SGUS) for diagnosing primary Sjögren's syndrome (SS) and to suggest modifications of the American-European Consensus Group (AECG) classification criteria. METHODSWe conducted a cross-sectional study in a prospective cohort of pati... Full description

Journal Title: Arthritis and rheumatism January 2013, Vol.65(1), pp.216-225
Main Author: Cornec, Divi
Other Authors: Jousse-Joulin, Sandrine , Pers, Jacques-Olivier , Marhadour, Thierry , Cochener, Béatrice , Boisramé-Gastrin, Sylvie , Nowak, Emmanuel , Youinou, Pierre , Saraux, Alain , Devauchelle-Pensec, Valérie
Format: Electronic Article Electronic Article
Language: English
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ID: E-ISSN: 1529-0131 ; DOI: 1529-0131 ; DOI: 10.1002/art.37698
Link: http://search.proquest.com/docview/1273122594/?pq-origsite=primo
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title: Contribution of salivary gland ultrasonography to the diagnosis of Sjögren's syndrome: toward new diagnostic criteria?
format: Article
creator:
  • Cornec, Divi
  • Jousse-Joulin, Sandrine
  • Pers, Jacques-Olivier
  • Marhadour, Thierry
  • Cochener, Béatrice
  • Boisramé-Gastrin, Sylvie
  • Nowak, Emmanuel
  • Youinou, Pierre
  • Saraux, Alain
  • Devauchelle-Pensec, Valérie
subjects:
  • Adult–Diagnostic Imaging
  • Aged–Diagnostic Imaging
  • Cross-Sectional Studies–Diagnostic Imaging
  • Female–Diagnostic Imaging
  • Humans–Diagnostic Imaging
  • Male–Diagnostic Imaging
  • Middle Aged–Diagnostic Imaging
  • Salivary Glands–Diagnostic Imaging
  • Sensitivity and Specificity–Diagnostic Imaging
  • Sjogren'S Syndrome–Diagnostic Imaging
  • Ultrasonography–Diagnostic Imaging
  • Abridged
ispartof: Arthritis and rheumatism, January 2013, Vol.65(1), pp.216-225
description: OBJECTIVETo determine the accuracy of salivary gland ultrasonography (SGUS) for diagnosing primary Sjögren's syndrome (SS) and to suggest modifications of the American-European Consensus Group (AECG) classification criteria. METHODSWe conducted a cross-sectional study in a prospective cohort of patients with suspected primary SS that was established between 2006 and 2011. The echostructure of the bilateral parotid and submandibular glands was graded from 0 to 4, and the gland size was measured; blood flow to the parotid gland was assessed using Doppler waveform analysis. The reference standard was a clinical diagnosis of primary SS as determined by a group of experts blinded to the results of SGUS. Receiver operating characteristic (ROC) curve analysis was performed to compare the diagnostic value of the 0-4-point echostructure grade for each of the 4 major salivary glands, the sum of the grades for the 4 glands, and the highest grade among the 4 glands. RESULTSOf the 158 patients in the study, 78 had a diagnosis of primary SS according to the experts, including 61 patients (78.2%) who met the AECG criteria. Doppler waveform analysis and gland size measurement showed poor diagnostic performance. The results of ROC curve analysis showed that the highest grade among the 4 glands provided the best diagnostic value. The optimal grade cutoff was 2 (62.8% sensitivity and 95.0% specificity). A weighted score was constructed using scores for the 5 variables selected by logistic regression analysis, as follows: (salivary flow×1.5)+(Schirmer's test×1.5)+(salivary gland biopsy×3)+(SSA/SSB×4.5)+(SGUS×2). According to ROC curve analysis, a score of ≥5 of 12.5 had 85.7% sensitivity and 94.9% specificity, compared with 77.9% sensitivity and 98.7% specificity for the AECG criteria. The addition of SGUS to the AECG criteria increased sensitivity to 87.0% but did not change specificity. CONCLUSIONModifications of the AECG criteria, including the addition of a SGUS score, notably improved diagnostic performance.
language: eng
source:
identifier: E-ISSN: 1529-0131 ; DOI: 1529-0131 ; DOI: 10.1002/art.37698
fulltext: fulltext
issn:
  • 15290131
  • 1529-0131
url: Link


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titleContribution of salivary gland ultrasonography to the diagnosis of Sjögren's syndrome: toward new diagnostic criteria?
creatorCornec, Divi ; Jousse-Joulin, Sandrine ; Pers, Jacques-Olivier ; Marhadour, Thierry ; Cochener, Béatrice ; Boisramé-Gastrin, Sylvie ; Nowak, Emmanuel ; Youinou, Pierre ; Saraux, Alain ; Devauchelle-Pensec, Valérie
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ispartofArthritis and rheumatism, January 2013, Vol.65(1), pp.216-225
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subjectAdult–Diagnostic Imaging ; Aged–Diagnostic Imaging ; Cross-Sectional Studies–Diagnostic Imaging ; Female–Diagnostic Imaging ; Humans–Diagnostic Imaging ; Male–Diagnostic Imaging ; Middle Aged–Diagnostic Imaging ; Salivary Glands–Diagnostic Imaging ; Sensitivity and Specificity–Diagnostic Imaging ; Sjogren'S Syndrome–Diagnostic Imaging ; Ultrasonography–Diagnostic Imaging ; Abridged
descriptionOBJECTIVETo determine the accuracy of salivary gland ultrasonography (SGUS) for diagnosing primary Sjögren's syndrome (SS) and to suggest modifications of the American-European Consensus Group (AECG) classification criteria. METHODSWe conducted a cross-sectional study in a prospective cohort of patients with suspected primary SS that was established between 2006 and 2011. The echostructure of the bilateral parotid and submandibular glands was graded from 0 to 4, and the gland size was measured; blood flow to the parotid gland was assessed using Doppler waveform analysis. The reference standard was a clinical diagnosis of primary SS as determined by a group of experts blinded to the results of SGUS. Receiver operating characteristic (ROC) curve analysis was performed to compare the diagnostic value of the 0-4-point echostructure grade for each of the 4 major salivary glands, the sum of the grades for the 4 glands, and the highest grade among the 4 glands. RESULTSOf the 158 patients in the study, 78 had a diagnosis of primary SS according to the experts, including 61 patients (78.2%) who met the AECG criteria. Doppler waveform analysis and gland size measurement showed poor diagnostic performance. The results of ROC curve analysis showed that the highest grade among the 4 glands provided the best diagnostic value. The optimal grade cutoff was 2 (62.8% sensitivity and 95.0% specificity). A weighted score was constructed using scores for the 5 variables selected by logistic regression analysis, as follows: (salivary flow×1.5)+(Schirmer's test×1.5)+(salivary gland biopsy×3)+(SSA/SSB×4.5)+(SGUS×2). According to ROC curve analysis, a score of ≥5 of 12.5 had 85.7% sensitivity and 94.9% specificity, compared with 77.9% sensitivity and 98.7% specificity for the AECG criteria. The addition of SGUS to the AECG criteria increased sensitivity to 87.0% but did not change specificity. CONCLUSIONModifications of the AECG criteria, including the addition of a SGUS score, notably improved diagnostic performance.
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titleContribution of salivary gland ultrasonography to the diagnosis of Sjögren's syndrome: toward new diagnostic criteria?
descriptionOBJECTIVETo determine the accuracy of salivary gland ultrasonography (SGUS) for diagnosing primary Sjögren's syndrome (SS) and to suggest modifications of the American-European Consensus Group (AECG) classification criteria. METHODSWe conducted a cross-sectional study in a prospective cohort of patients with suspected primary SS that was established between 2006 and 2011. The echostructure of the bilateral parotid and submandibular glands was graded from 0 to 4, and the gland size was measured; blood flow to the parotid gland was assessed using Doppler waveform analysis. The reference standard was a clinical diagnosis of primary SS as determined by a group of experts blinded to the results of SGUS. Receiver operating characteristic (ROC) curve analysis was performed to compare the diagnostic value of the 0-4-point echostructure grade for each of the 4 major salivary glands, the sum of the grades for the 4 glands, and the highest grade among the 4 glands. RESULTSOf the 158 patients in the study, 78 had a diagnosis of primary SS according to the experts, including 61 patients (78.2%) who met the AECG criteria. Doppler waveform analysis and gland size measurement showed poor diagnostic performance. The results of ROC curve analysis showed that the highest grade among the 4 glands provided the best diagnostic value. The optimal grade cutoff was 2 (62.8% sensitivity and 95.0% specificity). A weighted score was constructed using scores for the 5 variables selected by logistic regression analysis, as follows: (salivary flow×1.5)+(Schirmer's test×1.5)+(salivary gland biopsy×3)+(SSA/SSB×4.5)+(SGUS×2). According to ROC curve analysis, a score of ≥5 of 12.5 had 85.7% sensitivity and 94.9% specificity, compared with 77.9% sensitivity and 98.7% specificity for the AECG criteria. The addition of SGUS to the AECG criteria increased sensitivity to 87.0% but did not change specificity. CONCLUSIONModifications of the AECG criteria, including the addition of a SGUS score, notably improved diagnostic performance.
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titleContribution of salivary gland ultrasonography to the diagnosis of Sjögren's syndrome: toward new diagnostic criteria?
authorCornec, Divi ; Jousse-Joulin, Sandrine ; Pers, Jacques-Olivier ; Marhadour, Thierry ; Cochener, Béatrice ; Boisramé-Gastrin, Sylvie ; Nowak, Emmanuel ; Youinou, Pierre ; Saraux, Alain ; Devauchelle-Pensec, Valérie
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abstractOBJECTIVETo determine the accuracy of salivary gland ultrasonography (SGUS) for diagnosing primary Sjögren's syndrome (SS) and to suggest modifications of the American-European Consensus Group (AECG) classification criteria. METHODSWe conducted a cross-sectional study in a prospective cohort of patients with suspected primary SS that was established between 2006 and 2011. The echostructure of the bilateral parotid and submandibular glands was graded from 0 to 4, and the gland size was measured; blood flow to the parotid gland was assessed using Doppler waveform analysis. The reference standard was a clinical diagnosis of primary SS as determined by a group of experts blinded to the results of SGUS. Receiver operating characteristic (ROC) curve analysis was performed to compare the diagnostic value of the 0-4-point echostructure grade for each of the 4 major salivary glands, the sum of the grades for the 4 glands, and the highest grade among the 4 glands. RESULTSOf the 158 patients in the study, 78 had a diagnosis of primary SS according to the experts, including 61 patients (78.2%) who met the AECG criteria. Doppler waveform analysis and gland size measurement showed poor diagnostic performance. The results of ROC curve analysis showed that the highest grade among the 4 glands provided the best diagnostic value. The optimal grade cutoff was 2 (62.8% sensitivity and 95.0% specificity). A weighted score was constructed using scores for the 5 variables selected by logistic regression analysis, as follows: (salivary flow×1.5)+(Schirmer's test×1.5)+(salivary gland biopsy×3)+(SSA/SSB×4.5)+(SGUS×2). According to ROC curve analysis, a score of ≥5 of 12.5 had 85.7% sensitivity and 94.9% specificity, compared with 77.9% sensitivity and 98.7% specificity for the AECG criteria. The addition of SGUS to the AECG criteria increased sensitivity to 87.0% but did not change specificity. CONCLUSIONModifications of the AECG criteria, including the addition of a SGUS score, notably improved diagnostic performance.
doi10.1002/art.37698
urlhttp://search.proquest.com/docview/1273122594/
issn00043591
date2013-01