Sjögren's syndrome of the parotid gland: value of diffusion-weighted echo-planar MRI for diagnosis at an early stage based on MR sialography grading in comparison with healthy volunteers.

TY - JOUR

T1 - Sjögren's syndrome of the parotid gland: value of diffusion-weighted echo-planar MRI for diagnosis at an early stage based on MR sialography grading in comparison with healthy volunteers.

AU - Regier, Marc

AU - Ries, Thorsten

AU - Arndt, C

AU - Cramer, M C

AU - Graessner, J

AU - Reitmeier, Fabian

AU - Jaehne, Michael

AU - Adam, Gerhard

AU - Habermann, Christian

PY - 2009

Y1 - 2009

N2 - PURPOSE: To investigate the value of diffusion-weighted echo-planar imaging (DW-EPI) for quantifying functional changes of the parotid gland in Sjögren's disease and to evaluate whether ADC mapping allows for early diagnosis based on MR sialography grading. MATERIALS AND METHODS: Using a DW-EPI sequence at 1.5 T (b-factors: 0, 500 and 1000 sec/mm (2)), the parotid glands of 52 healthy volunteers and 13 patients with histologically verified affection of Sjögren's disease were examined. All scans were performed prior to and following gustatory stimulation with 5 ml of lemon juice. ADC maps were evaluated by placing an inordinate region-of-interest (ROI) enclosing the entire parotid gland. Sjögren's disease was graded based on MR sialography findings using a 4-point grading-scale. Statistics included student t-test and kappa-analysis. RESULTS: In healthy volunteers mean ADCs of 1.14 x 10 (-3 )mm (2) /sec before and 1.2 x 10 (-3) mm (2) /sec after stimulation were observed. Higher ADCs were determined for early-stage Sjögren's disease, averaging 1.22 x 10 (-3) mm (2) /sec before and 1.29 x 10 (-3) mm (2) /sec after stimulation. Advanced disease revealed significantly lower ADCs (0.97 x 10 (-3) mm (2) /sec (p = 0.002) before and 1.01 x 10 (-3) mm (2) /sec (p <0.001) after stimulation). CONCLUSION: DW-EPI seems to display functional changes of the parotid gland affected by Sjögren's disease. Combined with MR sialography, it might be a useful tool for discriminating healthy from affected glands and seems to allow differentiation between the early and advanced disease.

AB - PURPOSE: To investigate the value of diffusion-weighted echo-planar imaging (DW-EPI) for quantifying functional changes of the parotid gland in Sjögren's disease and to evaluate whether ADC mapping allows for early diagnosis based on MR sialography grading. MATERIALS AND METHODS: Using a DW-EPI sequence at 1.5 T (b-factors: 0, 500 and 1000 sec/mm (2)), the parotid glands of 52 healthy volunteers and 13 patients with histologically verified affection of Sjögren's disease were examined. All scans were performed prior to and following gustatory stimulation with 5 ml of lemon juice. ADC maps were evaluated by placing an inordinate region-of-interest (ROI) enclosing the entire parotid gland. Sjögren's disease was graded based on MR sialography findings using a 4-point grading-scale. Statistics included student t-test and kappa-analysis. RESULTS: In healthy volunteers mean ADCs of 1.14 x 10 (-3 )mm (2) /sec before and 1.2 x 10 (-3) mm (2) /sec after stimulation were observed. Higher ADCs were determined for early-stage Sjögren's disease, averaging 1.22 x 10 (-3) mm (2) /sec before and 1.29 x 10 (-3) mm (2) /sec after stimulation. Advanced disease revealed significantly lower ADCs (0.97 x 10 (-3) mm (2) /sec (p = 0.002) before and 1.01 x 10 (-3) mm (2) /sec (p <0.001) after stimulation). CONCLUSION: DW-EPI seems to display functional changes of the parotid gland affected by Sjögren's disease. Combined with MR sialography, it might be a useful tool for discriminating healthy from affected glands and seems to allow differentiation between the early and advanced disease.

M3 - SCORING: Zeitschriftenaufsatz

VL - 181

SP - 242

EP - 248

JO - ROFO-FORTSCHR RONTG

JF - ROFO-FORTSCHR RONTG

SN - 1438-9029

IS - 3

M1 - 3

ER -