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Sjögren's Syndrome: Comparison of Assessments with Quantitative Salivary Gland Scintigraphy and Contrast Sialography

Department of Radiology, Faculty of Medicine, and Department of Dental Radiology and Radiation Research, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan

Correspondence: For correspondence and reprints contact: Ichiro Yamada, MD, Department of Radiology, Faculty of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.

ABSTRACT

This study compared the quantitative parameters of salivary gland scintigraphy and the sialographic stages in patients with Sjögren's syndrome. Methods: One hundred sixteen patients suspected of having Sjögren's syndrome were examined with salivary gland scintigraphy and contrast sialography. When contrast sialography was used as the gold standard, Sjögren's syndrome was diagnosed in 50 of these 116 patients; Sjögren's syndrome was not seen in the other 66 patients. After injection of 370 MBq ^99mTc-sodium pertechnetate, dynamic salivary gland scintigraphy with lemon juice stimulation was performed for 50 min. Functional parameters for the parotid and submandibular glands were calculated, and scintigraphic and sialographic results were compared. Results: With the progression of sialographic stages from 0 to 4, the quantity of tracer accumulation decreased in the submandibular gland (P < 0.0001), and the quantity of tracer secretion decreased in the parotid gland (P < 0.0001). The sialographic stage in patients with Sjögren's syndrome was correlated with these scintigraphic parameters (P < 0.0001): sialographic stage = 3.243 – 0.337 x (submandibular gland uptake ratio) – 0.026 x (parotid gland maximum secretion). Conclusion: The decreased accumulation in the submandibular gland and the decreased secretion in the parotid gland were highly sensitive indicators of salivary gland disease in Sjögren's syndrome. The sialographic stage was correlated with these scintigraphic parameters.

Key Words: Sjögren's syndrome • salivary gland scintigraphy • sialography

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