摘要
目的:探讨超声评分系统联合剪切波弹性成像(SWE)对免疫球蛋白G4(IgG4)相关颌下腺炎及泪腺炎疗效的评估价值。方法:本研究为前瞻性队列研究,连续性纳入2022年9月至2024年12月期间就诊于首都医科大学附属友谊医院风湿免疫科门诊IgG4相关颌下腺及泪腺炎患者103例,根据治疗效果分为有效组(45例)和非有效组(58例)。所有患者治疗前后分别采用常规超声及SWE进行检查,对两组参数进行评估。通过logistic回归分析确定评估疗效的独立影响因素,并绘制受试者工作特征(ROC)曲线及列线图。结果:有效组与非有效组在性别和年龄上的差异均无统计学意义(P>0.05)。有效组颌/泪评分差值、评分变化率、杨氏模量平均值(Emean)差值、Emean变化率、杨氏模量最大值(Emax)差值、Emax变化率均高于非有效组,差异均有统计学意义(Z=-7.916、-7.680、-6.767、-6.722、-6.360、-5.957,P<0.05)。颌/泪评分差值(OR=2.90,P<0.001)和Emax差值(OR=1.18,P<0.05)对评估疗效有诊断价值。颌/泪评分差值评估治疗有效的ROC曲线下面积(AUC)为0.945,灵敏度为88.9%,特异度为94.8%,准确率为87.4%;Emax差值评估治疗有效的AUC为0.866,灵敏度为86.7%,特异度为70.7%,准确率为77.7%。二者联合评估的AUC为0.976,灵敏度为93.3%,特异度为94.8%,准确率为94.2%。结论:常规超声评分系统联合SWE对IgG4相关颌下腺炎及泪腺炎疗效评估具有较高的诊断价值,联合应用可显著提高准确率,为临床提供可靠影像学依据。
Objective:To explore the assessment value of ultrasound scoring system combined with shear wave elastography(SWE)on curative effect of IgG4-related submandibular and lacrimal gland inflammation.Methods:This study was a prospective cohort study.A total of 103 patients with IgG4-related submandibular and/or lacrimal gland inflammation who admitted to the Department of Rheumatology and Immunology of Beijing Friendship Hospital,Capital Medical University from September 2022 to December 2024 were consecutively included.They were divided into an effective group(45 cases)and a non-effective group(58 cases)based on the curative effect.All patients were assessed by conventional ultrasound and SWE before and after treatment.Logistic regression analysis was used to determine the independent influencing factors of assessing the curative effect,and then,a receiver operating characteristic(ROC)curve and nomograms were drawn.Results:There were no statistically significant differences in gender and age between the effective group and the non-effective group(P>0.05).The difference between the submandibular and lacrimal gland score,change rate of score,difference of mean Young's modulus(Emean),Emean change rate,difference of maximum value of Young's modulus(Emax),and Emax change rate in the effective group were all higher than those in the non-effective group,and the differences were statistically significant(Z=-7.916,-7.680,-6.767,-6.722,-6.360,-5.957,P<0.05),respectively.The difference between the submandibular and lacrimal gland score(OR=2.90,P<0.001)and the Emax difference(OR=1.18,P<0.05)had diagnostic value for assessing the curative effectiveness.The area under curve(AUC)value,sensitivity,specificity and accuracy of the difference between submandibular and lacrimal gland score were respectively 0.945,88.9%,94.8%and 87.4%in assessing the curative effectiveness.The above indicators of Emax difference were respectively 0.866,86.7%,70.7%and 77.7%in assessing the curative effectiveness.The above indicators of the combination of them were respectively 0.976,93.3%,94.8%and 94.2%.Conclusion:The combination of the conventional ultrasound scoring system and SWE has higher diagnostic value in assessing the curative effect of IgG4-related submandibular and lacrimal gland inflammation.The combined application can significantly improve the accuracy and provide reliable imaging reference for clinical practice.
作者
张晋槐
周明珠
刘燕鹰
胡向东
Zhang Jinhuai;Zhou Mingzhu;Liu Yanying;Hu Xiangdong(Department of Ultrasound,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Ultrasound,Beijing Haidian Hospital,Haidian Section of Peking University Third Hospital,Beijing 100080,China;Department of Rheumatology,Beijing Friendship Hospital,Capital Medical University,Beijing 100080,China)
出处
《中国医学装备》
2025年第5期10-15,共6页
China Medical Equipment
基金
通州区科学技术委员会(KJ2023CX004)。
