What is the best salivary gland ultrasonography scoring methods for the diagnosis of primary or secondary Sjögren's syndromes?

Amélie Martel (1, 2) , Guillaume Coiffier (3) , Aurore Bleuzen (4) , Jean E Goasguen (5) , Michel de Bandt (6) , Christophe Deligny (7) , Julie Magnant (2) , Nicole Ferreira (2) , Elisabeth Diot (2) , Aleth Perdriger (2) , Francois Maillot (8, 2)

1 CHU Trousseau [Tours]
2 UT - Université de Tours
3 NuMeCan - Nutrition, Métabolismes et Cancer
4 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
5 UR - Université de Rennes
6 CHU de la Martinique [Fort de France]
7 Hôpital Pierre Zobda-Quitman [CHU de la Martinique]
8 Hôpital Bretonneau

Objective: To evaluate the performance of salivary gland ultrasonography for the diagnosis of primary and secondary Sjögren's syndromes (pSS and sSS).Method: Multicenter cross-sectional study on 97 patients with clinical sicca symptoms. The pSS (n = 39) and the sSS (n = 22) met the American-European Consensus Group (AECG) classification criteria. The control patients (n = 36) with sicca symptoms did not fulfill the AECG criteria. Four scores were used to evaluate the 4 major salivary gland echostructure: the Salaffi score (0-16), Jousse-Joulin score (0-4), Hocevar score (0-48) and Milic score (0-12).Results: The medians of ultrasonographic (US) scores were higher in the pSS and sSS groups than in the control group (p <0.001). The receiver-operating characteristic (ROC) curves and the positive likelihood ratio (LR+) of the four scores showed a good diagnostic performance for the US diagnosis of pSS and sSS. Respectively, for pSS and sSS, the AUC were 0.891 (95%CI 0.812-0.970) and 0.824 (95%CI 0.695-0.954) for Hocevar score, 0.885 (95%CI 0.804-0.965) and 0.808 (95%CI 0.673-0.943) for Milic score, 0.915 (95%CI 0.848-0.982) and 0.844 (95%CI 0.724-0.965) for Salaffi score, 0.897 (95%CI 0.821-0.973) and 0.851 (95%CI 0.735-0.968) for Jousse-Joulin score. This study showed an interesting inter-observer reproducibility (kappa=0.714 ± 0.131) of the US evaluation with 85,7 % agreement between reader to determine the pathological character of the salivary glands.Conclusion: Salivary gland US is a simple, non-invasive and performant imaging procedure for the diagnosis of pSS and sSS, with Salaffi, Milic and Jousse-Joulin scores.

Mots clés: ultrasound; Sjogren's syndrome; Salivary gland

Domaines: Rhumatologie et système ostéo-articulaire; Imagerie

Amélie Martel, Guillaume Coiffier, Aurore Bleuzen, Jean E Goasguen, Michel de Bandt, et al.. What is the best salivary gland ultrasonography scoring methods for the diagnosis of primary or secondary Sjögren's syndromes?. Joint Bone Spine, 2019, 86 (2), pp.211-217. ⟨10.1016/j.jbspin.2018.06.014⟩. ⟨hal-01894638⟩