唾液腺动态显像定量分析在诊断原发干燥综合征中的应用价值

目的探讨应用99mTcO4-唾液腺动态显像定量分析方法诊断原发干燥综合征（primary sjogren syndrome,pSS）的临床价值。方法对44例pSS患者与28例健康对照者进行99mTcO4-唾液腺动态显像,获得腮腺及颌下腺的动态显像图像,通过勾画腺体的感兴趣区（region of interest,ROI）,获得腮腺及颌下腺的时间-放射性曲线（time-activity curve,TAC）及功能参数：摄取指数（uptake radio,UR）、相对摄取率（relative uptake radio,S/T）、酸刺激后腺体排泄率（secretion rate,SR）、酸刺激后平均排泌速率（V）。分析pSS患者与健康对照者各项功能参数的差异,并利用受试者工作特征曲线（Receiver operatorcharacteristic curve,ROC曲线）评价定量分析的准确性。结果 1）与对照组相比,pSS组唾液腺摄取功能（UR、S/T）明显降低,酸刺激后唾液腺排泌量（SR）明显减少,排泌速度（V）明显缓慢（均为P〈0.01）。2）ROC曲线分析显示：在各项功能参数中V诊断pSS的灵敏度最高,UR诊断pSS的特异性最高。结论99mTcO4-唾液腺动态显像定量分析方法对原发干燥综合征的诊断具有较高的敏感度和特异性,对患者唾液腺的摄取及排泌功能的判断具有重要的临床价值。

Application of quantitative dynamic salivary gland images in diagnosis of primary Sjogren syndrome

Objective To study the application of quantitative 99mTcO4-dynamic salivary gland images in diagnosis of primary Sjogren syndrome（pSS）.Methods Forty-four pSS patients served as a pSS group and 28 healthy subjects served as a control group in this study.Their 99mTcO4-dynamic salivary gland images were observed.Time-activity curve（TAC） of gland and its function parameters,including uptake ratio（UR）,relative uptake ratio（S/T）,gland secretion rate（SR） and mean secretion velocity（SV） after acid stimulation,were collected from the drawing region of interest（ROI）.Difference in each function parameter was analyzed between pSS group and control group.The accuracy of quantitative 99mTcO4-dynamic salivary gland images was assessed according to the ROC curve.Results The gland UR and S/T were significantly lower,the gland SR after acid stimulation was significantly lower,the gland SV after acid stimulation was significantly slower in pSS group than in control group（P﹤0.01）.ROC curve showed that the sensitivity of gland SV and the specificity of gland UR were the highest in diagnosis of pSS among the parameters.Conclusion Quantitative99mTcO4-dynamic salivary gland images can be used in diagnosis of pSS with a high sensitivity and specificity,thus playing an important role in assessment of the uptake and secretion function of salivary gland.