Welche Rolle spielt die Ultraschalldiagnostik beim Sjögren-Syndrom?

Zusammenfassung

Die Klassifikationskriterien des Sjögren-Syndroms beinhalten bisher zwar bildgebende Verfahren wie Sialografie und Szintigrafie, nicht aber die Sonografie. Die Sonografie der großen Speicheldrüsen ist einfach und rasch sowie für den Patienten angenehm durchzuführen. Es können die Linearschallköpfe verwendet werden, die dem Rheumatologen für die Gelenksonografie ohnehin zur Verfügung stehen. Eine Farbdopplersonografie verbessert die diagnostische Aussage nicht. Untersucht werden die Glandula parotis und submandibularis auf beiden Seiten. Im Falle eines Sjögren-Syndroms sind sie echoarm und inhomogen. Die Glandulae submandibularis sind häufig atrophisch (sagittaler Durchmesser <8 mm), die Glandulae parotis insbesondere bei akuten Schüben manchmal vergrößert (sagittaler Durchmesser >20 mm). Die Sensitivität der Sonografie für die Diagnose liegt zwischen 60 und 90%, die Spezifität bei deutlich über 90%. Damit ist die Sonografie ein wichtiger Baustein in der Diagnostik des Sjögren Syndroms geworden.

Abstract

The classification criteria for Sjögren's syndrome include imaging modalities such as sialography and scintigraphy, but ultrasound has not yet become part of criteria. Ultrasound of the salivary glands is a simple, cheap and quick imaging technique that is convenient for the patient. Most rheumatologists have access to ultrasound. They can apply the same linear probes that they are using for musculoskeletal ultrasound to examine the salivary glands. The use of color Doppler ultrasonography does not significantly add to the diagnosis. Ultrasound is performed on both parotid and submandibular glands. They become hypoechoic and inhomogeneous in Sjögren's syndrome. The submandibular glands are often atrophic with a sagittal diameter of <8 mm. The parotid glands are larger than normal, particularly in disease flares, with a sagittal diameter of >20 mm. The sensitivities for the diagnosis of Sjögren's syndrome range between 60 and 90%, the specificities are fair above 90%. Thus, ultrasonography has become an important tool in the diagnosis of Sjögren's syndrome.

Schlüsselwörter

Sjögren-Syndrom - Sonografie - MRT - Sialografie - Speicheldrüsenszintigrafie

Key words

Sjögren's syndrome - ultrasonography - magnetic resonance imaging - sialography - scintigraphy

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