Effectiveness of imaging modalities for screening IgG4-related dacryoadenitis and sialadenitis (Mikulicz's disease) and for differentiating it from Sjögren's syndrome (SS), with an emphasis on sonography.

摘要: The aim of this study was to clarify the effectiveness various imaging modalities and characteristic features in screening IgG4-related dacryoadenitis sialadenitis (IgG4-DS), show differences between IgG4-DS Sjogren’s syndrome (SS). Thirty-nine patients with IgG4-DS, 51 SS 36 normal salivary glands were enrolled. Images parotid submandibular obtained using sonography, 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT), computed (CT) magnetic resonance (MRI) retrospectively analyzed. Six oral maxillofacial radiologists randomly reviewed arranged image sets under blinded conditions. Each observer scored confidence rating regarding presence findings a 5-grade system. After scoring findings, diagnosis made as normal, or SS, considering all for each case. On multiple hypoechoic areas hyperechoic lines and/or spots obscuration gland configuration detected mainly (median scores 4, 4 3, respectively). Reticular nodal patterns observed primarily score 5). FDG-PET/CT revealed tendency abnormal 18F-FDG accumulation swelling both particularly glands. MRI, had high salt-and-pepper appearance cystic 4.5). Sonography showed highest values among four sensitivity, specificity accuracy. There significant sonography CT (p = 0.0001) 0.0058) concerning Changes affected by could be easily (characteristic bilateral nodal/reticular change) (abnormal accumulation). Even inexperienced observers detect these findings. In addition, also differentiate SS. Consequently, we recommend modality because it is easy use, involves no radiation exposure an effective modality.