声触诊组织成像定量技术对涎腺干燥综合征的诊断价值

doi:10.3877/cma.j.issn.1672-6448.2021.01.004

目的

探讨声触诊组织成像定量技术（VTIQ）对涎腺干燥综合征的诊断价值。

方法

收集2018年11月至2019年12月兰州医科大学第二医院干燥综合征患者50例（试验组）和同期健康志愿者60名（对照组），运用VTIQ技术分别测量双侧腮腺及颌下腺剪切波速度（SWV），采用t检验比较2组患者SWV值的差异，绘制受试者操作特征（ROC）曲线，获取诊断干燥综合征最佳截断值，评价VTIQ对涎腺干燥综合征的诊断价值；并采用t检验比较原发性与继发性干燥综合征SWV值的差异。

结果

试验组患者腮腺、颌下腺SWV值均高于对照组［（2.39±0.31）m/s vs （1.94±0.22）m/s；（2.42±0.33）m/s vs （2.14±0.29）m/s］，差异具有统计学意义（t=12.13、6.82，P均＜0.001）。以腮腺SWV≥2.035 m/s、颌下腺SWV≥2.115 m/s作为诊断涎腺干燥综合征的最佳截断值。原发性干燥综合征患者腮腺SWV值较继发性高［（2.46±0.36）m/s vs （2.27±0.16）m/s］，二者之间差异具有统计学意义（t=3.68，P＜0.001）；颌下腺SWV值较继发性患者低［（2.37±0.31）m/s vs （2.50±0.34）m/s］，但二者之间差异无统计学意义（P＞0.05）。

结论

VTIQ技术可定量反映干燥综合征患者涎腺组织硬度改变，且原发性与继发性干燥综合征患者涎腺组织硬度具有一定差异，VTIQ对诊断涎腺干燥综合征具有较高的临床价值。

关键词: 干燥综合征, 声触诊组织成像定量技术, 腮腺, 颌下腺

Objective

To assess the value of virtual touch tissue imaging quantification (VTIQ) in the diagnosis of Sj?gren's syndrome (SS).

Methods

Totally 50 patients with Sj?gren's syndrome (experimental group) and 60 healthy volunteers (control group) were enrolled at Lanzhou University Second Hospital from November 2018 to December 2019. VTIQ technology was performed on bilateral parotid and submandibular glands to obtain shear wave velocity (SWV) value, which was compared between the two groups by t test. ROC curves were drawn to obtain the best cut-off value of SWV and estimate the role of VTIQ in the diagnosis of SS. The difference of SWV was also compared between primary and secondary SS by t test.

Results

SWV values of the parotid gland and submandibular gland in the experimental group were statistically higher than those of the control group [(2.39±0.31) m/s vs (1.94±0.22) m/s, t=12.13, P＜0.001; (2.42±0.33) m/s vs (2.14±0.29) m/s, t=6.82, P＜0.001)]. The optimal cut-off values to diagnose SS in the parotid gland and submandibular gland were 2.035 m/s and 2.115 m/s, respectively. In the parotid gland, the SWV value of primary SS was statistically higher than that of secondary SS [(2.46±0.36) m/s vs (2.27±0.16) m/s, t=3.68, P＜0.001], but there was no statistical difference in the submandibular gland [(2.37±0.31) m/s vs (2.50±0.34) m/s, P＞0.05].

Conclusion

VTIQ technology can quantitatively show the tissue hardness changes in the salivary gland of SS patients. There is a certain difference in the hardness of salivary gland tissue between primary and secondary SS patients. VTIQ technology has high clinical value in the diagnosis of SS.

Key words: Sj?gren's syndrome, Virtual touch tissue imaging quantification, Parotid gland, Submandibular gland

图1 健康志愿者腮腺超声图像。图a涎腺超声示腮腺实质回声细密、均匀；图b彩色多普勒示腮腺内见点状血流信号；图c声触诊组织成像定量技术测量腮腺剪切波速度值为1.89 m/s

图2 干燥综合征患者腮腺超声图像。图a涎腺超声示腮腺实质回声不均匀，内见低回声区；图b彩色多普勒示腮腺内见点状血流信号；图c声触诊组织成像定量技术测量腮腺剪切波速度值为2.43 m/s

表1 同组内腮腺、颌下腺剪切波速度值比较（m/s，

x ˉ

±s）

侧别	试验组（50例）		对照组（60名）
侧别	腮腺	颌下腺	腮腺	腮腺
左侧	2.41±0.34	2.45±0.31	1.94±0.21	2.14±0.27
右侧	2.36±0.26	2.39±0.34	1.94±0.24	2.15±0.31
t值	1.39	1.57	－0.78	－0.49
P值	0.171	0.124	0.983	0.627

表1 同组内腮腺、颌下腺剪切波速度值比较（m/s，

x ˉ

±s）

侧别	试验组（50例）		对照组（60名）
侧别	腮腺	颌下腺	腮腺	腮腺
左侧	2.41±0.34	2.45±0.31	1.94±0.21	2.14±0.27
右侧	2.36±0.26	2.39±0.34	1.94±0.24	2.15±0.31
t值	1.39	1.57	－0.78	－0.49
P值	0.171	0.124	0.983	0.627

表2 不同组间腮腺、颌下腺剪切波速度值比较（m/s，

x ˉ

±s）

组别	例数	腮腺	颌下腺
试验组	50	2.39±0.31	2.42±0.33
对照组	60	1.94±0.22	2.14±0.29
t值		12.13	6.82
P值		＜0.001	＜0.001

表2 不同组间腮腺、颌下腺剪切波速度值比较（m/s，

x ˉ

±s）

组别	例数	腮腺	颌下腺
试验组	50	2.39±0.31	2.42±0.33
对照组	60	1.94±0.22	2.14±0.29
t值		12.13	6.82
P值		＜0.001	＜0.001

图3 声触诊组织成像定量技术诊断干燥综合征患者腮腺、颌下腺的受试者操作特征曲线

表3 原发性与继发性干燥综合征患者腮腺、颌下腺剪切波速度值比较（m/s，

x ˉ

±s）

组别	例数	腮腺	颌下腺
原发性	30	2.46±0.36	2.37±0.31
继发性	20	2.27±0.16	2.50±0.34
t值		3.68	－1.96
P值		＜0.001	0.053

表3 原发性与继发性干燥综合征患者腮腺、颌下腺剪切波速度值比较（m/s，

x ˉ

±s）

组别	例数	腮腺	颌下腺
原发性	30	2.46±0.36	2.37±0.31
继发性	20	2.27±0.16	2.50±0.34
t值		3.68	－1.96
P值		＜0.001	0.053

图4 声触诊组织成像定量技术测量原发性干燥综合征患者涎腺超声图像。图a示腮腺剪切波速度值为2.78 m/s；图b示颌下腺剪切波速度值为2.13 m/s

图5 声触诊组织成像定量技术测量继发性干燥综合征患者涎腺超声图像。图a示腮腺剪切波速度值为2.34 m/s；图b示颌下腺剪切波速度值为2.26 m/s

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Clinical value of virtual touch tissue imaging quantification in diagnosing salivary gland Sjögren's syndrome

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Clinical value of virtual touch tissue imaging quantification in diagnosing salivary gland Sjögren's syndrome