Ultrasonography of salivary glands: an evolving approach for the diagnosis of Sjögren's syndrome

Abstract

Sjögren's syndrome (SS) is a chronic autoimmune rheumatic disease, which primarily affects the exocrine glands. The diagnosis of SS is based on American–European diagnostic criteria that include, as independent diagnostic items, imaging techniques such as sialography and scintigraphy. In recent years, new imaging techniques—including MRI, magnetic resonance sialography and ultrasonography of the salivary glands—have been used to diagnose SS. Ultrasonography is a noninvasive method that provides information about the changes to major salivary glands during inflammation. In a recently published report by Wernicke and colleagues, ultrasonography revealed decreased echogenicity and volume of submandibular glands in patients with SS but not in normal individuals, with a specificity of more than 90% and sensitivity close to 60%. Nevertheless, this technique should be carefully validated, using disease-control patients with dry mouth and comparison with other diagnostic items. The clarification of these matters will enable the use of ultrasonography for diagnostic purposes in SS.