ultrasound setting and scanning of the thyroid gland for examining sjogren&#39;s syndrome

쇼그렌 증후군의 타액선 초음파 검사 기법

Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration in exocrine glands, including the salivary and lacrimal glands. Xerostomia, keratoconjunctivitis sicca, and extraglandular manifestations, including arthralgia, cytopenia, and lymphoma, are described in patients with SS. SS can be divided into primary and secondary types, in which the latter occurs in association with other connective tissue diseases. In the 2016 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for primary SS, anti-SSA/Ro positivity and lymphocytic infiltration in labial salivary gland biopsy contributed to the two major criteria, whereas Schirmer's test, ocular staining score, and unstimulated salivary flow represented the rest of the minor criteria1. The criteria are summarized in Table 1. Labial biopsy is an invasive procedure with potential complications, including sampling error, sensory loss, and hematoma formation2. Ocular staining tests and salivary flow assessment require specialized settings and might not be widely available. 
Salivary gland ultrasonography (SGUS) is a non-invasive imaging modality that provides a detailed examination of the superficial salivary gland structure, which is commonly affected in patients with SS. Lymphocytic infiltration and inflammation in the salivary glands often lead to fatty infiltration, fibrosis, and loss of parenchyma, resulting in parenchymal inhomogeneity detected in SGUS3. The Outcome Measures in Rheumatology Clinical Trials (OMERACT) working group derived an ultrasound scoring system from grades 0 to 3 to semi-quantify inhomogeneity and the presence of hypoechoic areas within the parotid or submandibular glands4. A cutoff of grade 2 or above in at least one gland was found to correlate with positive labial biopsies, sialometry, and positive autoantibodies5. It demonstrated excellent specificity and good sensitivity in fulfilling the 2016 ACR/EULAR classification criteria for primary SS when given similar weight as the minor criteria. This protocol presents a standardized and practical approach for diagnosing SGUS in SS in clinical settings.

저자 스포트라이트: 결합 조직 질환 연구에서 표준화된 타액선 초음파 프로토콜에 초점

쇼그렌 증후군에 대한 타액선의 초음파 평가: 진단 및 모니터링 통찰력

Our research focus is connective tissue diseases, including Sjogren's syndrome, and we will describe a standardized approach to saliva and ultrasound in diagnosing Sjogren's syndrome. We hope the protocol will be useful for clinicians unfamiliar with doing ultrasound to enhance its application in clinical practice. Ultrasound is a powerful tool in evaluating various rheumatological conditions, including arthritis, sjogren syndrome, and interstitial lung disease.It is helpful in diagnosis, monitoring and prognostication. It can be applied as an outcome measure in clinical studies such as detecting subclinical synovitis to assess the risk of rheumatoid arthritis progression. Ultrasound is an operator-dependent procedure and the result may be unreliable if inexperienced, hence performed.Well validated and quantitative measurements are often needed to standardize the description and reporting of pathological sonographic findings before they can be applied in clinical practice and research. In this procedure, we will describe how to conduct a salivary gland ultrasound in patients with sicker symptoms. This approach is easy to perform and can usually be completed within 10 to 15 minutes.We'll also demonstrate techniques to perform reliable and reproducible results to ensure the quality of the ultrasound scanning. Our center will continue to research on applying ultrasound in diagnosis and monitoring in rheumatology. We will research utilizing lung ultrasound for screening of interstitial lung disease associated with connective tissue diseases, hoping to improve the current screening strategy for lung fibrosis in rheumatology patients.

쇼그렌 증후군을 검사하기 위한 갑상선의 초음파 설정 및 스캔

시작하려면 10메가헤르츠의 고주파 선형 변환기를 선택하십시오. 초음파를 B 모드로 설정하고 프로브의 가장 높은 주파수를 사용합니다. 깊이를 3cm로 조정하고 50%에서 60%를 얻습니다. 목을 약간 펴고 환자를 앙와위 자세로 놓고 베개를 사용하여 환자의 머리를 지지합니다.가로 이미지의 경우 마커가 환자의 오른쪽을 가리키도록 프로브의 방향을 지정합니다. 종방향 스캔의 경우 마커를 두부 쪽에 배치합니다. 프로브 표면에 젤을 바릅니다.갑상선 연골 아래에 프로브를 놓고 갑상선을 스캔합니다. 얻은 이미지를 저장합니다. 갑상선의 우엽과 좌엽을 연결합니다.정상적인 갑상선의 초음파(echogenicity)를 기준으로 생각해 보십시오. 동반되는 갑상선 질환의 경우 주변 근육의 초음파성과 초음파성을 비교하십시오.

Research

JoVE Journal

Medicine

Ultrasound Setting and Scanning of the Thyroid Gland for Examining Sjogren&#39;s Syndrome

Ultrasonographic Evaluation of Salivary Glands for Sjogren's Syndrome: Diagnostic and Monitoring Insights

Sjogren's syndrome (SS) is a chronic autoimmune condition commonly affecting the exocrine glands, causing oral or ocular dryness and extraglandular ...

연구

의학

Ultrasound Scanning of the Parotid Gland for Examining Sjogren&#39;s Syndrome

쇼그렌 증후군을 검사하기 위한 귀밑샘의 초음파 검사

Ultrasound Scanning of the Submandibular Gland for Examining Sjogren&#39;s Syndrome

쇼그렌 증후군을 검사하기 위한 턱밑샘의 초음파 스캔