Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 11:58:e20240121.
doi: 10.1590/0100-3984.2024.0121. eCollection 2025 Jan-Dec.

Effectiveness of shear wave elastography for assessing major salivary gland involvement in ankylosing spondylitis

Irfan Atik  1 , Seda Atik  1 , Enes Gul  1
Affiliations

Effectiveness of shear wave elastography for assessing major salivary gland involvement in ankylosing spondylitis

Irfan Atik et al. Radiol Bras. .

Abstract
in English, Portuguese

Objective: To use shear wave elastography (SWE) in the evaluation of salivary glands in patients with ankylosing spondylitis (AS) who present with sicca symptoms.

Materials and methods: This was a prospective controlled study of patients diagnosed with AS and exhibiting sicca symptoms (study group) and of healthy volunteers (control group). The levels of antinuclear, anti-Ro, and anti-La antibodies were determined in blood samples. In both groups, parotid and submandibular glands were evaluated by ultrasound and tissue stiffness was determined by SWE. Intraclass correlation coefficients were used in order to assess reliability. The differences between the two groups were assessed by statistical methods, and a ROC curve analysis was performed to determine the predictive values.

Results: A total of 66 patients with AS and 71 healthy volunteers were included in the study. There were no significant differences between the groups in terms of age or sex (p > 0.05). The intraand inter-rater reliability of SWE were good for the parotid gland (0.81-0.85 and 0.80, respectively) and for the submandibular gland (0.85-0.88 and 0.80, respectively). Statistically significant differences were found. Tissue stiffness in the parotid and submandibular glands, as determined by SWE, was significantly greater in the study group than in the control group (p < 0.05).

Conclusion: Although there was no histopathological correlation in the parotid and submandibular salivary glands of patients with AS and sicca symptoms compared with the healthy volunteers, quantitative measurements showed greater tissue stiffness in the former group. In patients with AS, SWE guides salivary gland biopsy, which is the gold standard for diagnosing Sjögren's syndrome.

Objetivo: Foi realizada avaliação, utilizando elastografia por onda de cisalhamento (EOC), da glândula salivar de pacientes com espondilite anquilosante (EA) que apresentavam sintomas de secura.

Materiais e métodos: Em pacientes diagnosticados com EA e exibindo sintomas de secura, os níveis de anticorpos antinucleares, anticorpos anti-Ro e anti-La no sangue foram investigados. As glândulas parótidas e submandibulares bilaterais foram avaliadas utilizando ultrassom em ambos os grupos de pacientes e controle, e a rigidez do tecido foi registrada usando EOC. Estimativas do coeficiente de correlação intraclasse foram usadas para avaliar a confiabilidade. A diferença entre os dois grupos foi avaliada por métodos estatísticos. A análise da curva ROC foi realizada para determinar os valores de predição.

Resultados: Foram incluídos no estudo 66 pacientes com EA e 71 voluntários saudáveis. Não houve diferenças significativas em idade e sexo entre os grupos (p > 0,05). A confiabilidade intra-avaliadores e interavaliadores da EOC para a glândula parótida (0,81-0,85 e 0,80) e glândula submandibular (0,85-0,88 e 0,80) foi considerada boa. Diferenças estatisticamente significantes foram encontradas nas medidas da EOC da glândula parótida e submandibular em pacientes com EA, indicando aumento da rigidez no grupo de pacientes (p < 0,05).

Conclusão: Embora não tenha havido correlação histopatológica nas glândulas salivares parótidas e submandibulares bilaterais de pacientes com EA com sintomas de secura em comparação ao grupo controle, as medições quantitativas mostraram aumento da dureza do tecido. O uso da EOC em pacientes com EA orienta a biópsia da glândula salivar, que é o padrão ouro para o diagnóstico de síndrome de Sjögren.

Keywords: Elasticity imaging techniques/methods.; Inflammation; Salivary glands/physiopathology; Spondylitis; Ultrasonography/methods; ankylosing/diagnostic imaging.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Evaluation of the submandibular gland by SWE in the transverse plane, showing a quality indicator (a) and measurement of tissue stiffness (in kPa) with three equal regions of interest (b).
Figure 2
Figure 2
ROC curves plotted for the left and right parotid glands (a and b, respectively), as well as for the left and right submandibular glands (c and d, respectively), to evaluate stiffness by using SWE in patients with AS.
See this image and copyright information in PMC

References

    1. Negrini S, Emmi G, Greco M, et al. Sjögren’s syndrome: a systemic autoimmune disease. Clin Exp Med. 2022;22:9–25. - PMC - PubMed
    1. Sarı SY, Yılmaz MT, Elmalı A, et al. Turkish translation and validation of the Xerostomia Inventory. Arch Rheumatol. 2022;37:351–360. - PMC - PubMed
    1. Tecer D, Büyüksireci DE, Günedi Z, et al. Muscle architecture in patients with primary Sjögren syndrome. Arch Rheumatol. 2022;38:101–108. - PMC - PubMed
    1. Kobak S, Kobak AC, Kabasakal Y, et al. Sjögren’s syndrome in patients with ankylosing spondylitis. Clin Rheumatol. 2007;26:173–175. - PubMed
    1. Brandt J, Rudwaleit M, Eggens U, et al. Increased frequency of Sjögren’s syndrome in patients with spondyloarthropathy. J Rheumatol. 1998;25:718–724. - PubMed

LinkOut - more resources