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目的探讨干燥综合征(SS)的腮腺MRI影像学表现。方法根据美国风湿病学会SS分类标准将因口眼干燥就诊的患者22例分为SS组(15例)和非SS组(7例),另外选取10例健康志愿者作为对照组。行常规腮腺MRI及腮腺导管成像(MRS)检查,计算T1WI和T2WI信号强度差,并进行脂肪信号和腮腺导管扩张程度分级,分析常规MRI、MRS及二者联合应用对SS的诊断效能。结果对照组和非SS组腮腺常规MRI信号均匀;SS组出现双侧或单侧腮腺信号不均匀,T1WI和T2WI均见多发弥漫分布的高信号,抑脂T2WI上呈低信号;对照组和非SS组MRS均未见腮腺末梢导管扩张,SS组患者表现为不同程度腮腺末梢导管扩张。SS组患者30个腮腺中,常规MRI和MRS分别检出病变腮腺28个和24个,而二者联合应用检出了全部30个病变。结论 SS患者腮腺MRI显示弥漫性脂肪沉积,MRS显示弥漫性末梢导管扩张的特征性表现,结合分级可评估腮腺受累程度。MRI可作为SS的首选检查手段,联合MRS可提高诊断准确性。
Objective To investigate parotid MRI features of Sjogren’s syndrome (SS). Methods According to the American College of Rheumatology SS classification criteria, 22 patients with dry eye due to dry mouth were divided into SS group (n = 15) and non-SS group (n = 7). 10 healthy volunteers were selected as control group. Routine parotid MRI and parotid duct imaging (MRS) were performed to calculate the signal intensity difference between T1WI and T2WI. The fat signal and parotid duct dilatation grade were graded to analyze the diagnostic efficacy of conventional MRI, MRS and their combination on SS. Results The MRI signal of Parotid gland in control group and non-SS group was uniform. The signal of parotid gland in SS group was not uniform, the signal of multiple diffuse distribution was found in both T1WI and T2WI, and the signal was low in T2WI. There was no parotid ductal dilatation in the MRS patients in the SS group. The patients in the SS group presented with different degrees of parotid ductal dilatation. Of the 30 parotid glands in SS group, 28 and 24 parotid lesions were detected by conventional MRI and MRS, respectively, and the combination of the two detected all 30 lesions. Conclusions MRI findings of parotid gland in patients with SS show diffuse fat deposition. MRS shows the characteristic manifestations of diffuse peripheral duct dilatation. Combined with grading, the extent of parotid gland involvement can be assessed. MRI can be used as the first choice of SS examination, combined with MRS can improve the diagnostic accuracy.