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<p>To examine whether salivary gland ultrasonography (SGUS) and scintigraphy (SGS) reflect systemic disease activity (ESSDAI) and patient-reported index (ESSPRI) in primary Sjögren’s disease (PSD). We retrospectively enrolled 118 patients undergoing SGUS and SGS during diagnostic workup of dryness symptoms, which ultimately led to labial biopsy-confirmed PSD. SGUS was scored using the Outcome Measures in Rheumatology Clinical Trials (OMERACT) system (range 0–12). SGS analysis relied on time-activity curve-derived parotid and submandibular uptake ratios and excretion fractions. Unstimulated salivary flow rate (USFR) was also assessed. Associations were evaluated using correlation and logistic regression. OMERACT scores showed a weak but significant correlation with ESSDAI (ρ = 0.329, <i>p</i> &lt; 0.001), whereas SGS parameters were not associated with ESSDAI or ESSPRI (all <i>p</i> &gt; 0.05). ESSDAI and ESSPRI were weakly correlated (ρ = 0.252, <i>p</i> = 0.006). OMERACT scores differed significantly across ESSDAI categories (<i>p</i> = 0.001), whereas SGS parameters did not. In multivariable analysis, anti-SSA/Ro positivity (<i>p</i> = 0.006) and higher OMERACT scores (<i>p</i> &lt; 0.001) independently predicted moderate-to-high ESSDAI (ESSDAI ≥ 5). No imaging parameter predicted high ESSPRI (ESSPRI ≥ 5) (all <i>p</i> &gt; 0.05); however, USFR was strongly associated with symptom burden (<i>p</i> &lt; 0.001). The final models showed good discrimination (AUC 0.76 for ESSDAI and 0.74 for ESSPRI). SGUS reflects systemic disease activity, whereas SGS has limited clinical value. Patient-reported burden is more closely related to objective salivary hypofunction than to imaging findings. Integrating structural imaging, functional assessment, and patient-reported symptoms in PSD provides complementary information for disease assessment.</p>

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Imaging correlates of disease activity and patient-reported symptoms in primary Sjögren’s disease: an ultrasonographic and scintigraphic study

  • 期刊论文

  • 发表日期：

    2026年5月23日

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  • Josipa Vukšić,
  • Domagoj Kustić

摘要

To examine whether salivary gland ultrasonography (SGUS) and scintigraphy (SGS) reflect systemic disease activity (ESSDAI) and patient-reported index (ESSPRI) in primary Sjögren’s disease (PSD). We retrospectively enrolled 118 patients undergoing SGUS and SGS during diagnostic workup of dryness symptoms, which ultimately led to labial biopsy-confirmed PSD. SGUS was scored using the Outcome Measures in Rheumatology Clinical Trials (OMERACT) system (range 0–12). SGS analysis relied on time-activity curve-derived parotid and submandibular uptake ratios and excretion fractions. Unstimulated salivary flow rate (USFR) was also assessed. Associations were evaluated using correlation and logistic regression. OMERACT scores showed a weak but significant correlation with ESSDAI (ρ = 0.329, p < 0.001), whereas SGS parameters were not associated with ESSDAI or ESSPRI (all p > 0.05). ESSDAI and ESSPRI were weakly correlated (ρ = 0.252, p = 0.006). OMERACT scores differed significantly across ESSDAI categories (p = 0.001), whereas SGS parameters did not. In multivariable analysis, anti-SSA/Ro positivity (p = 0.006) and higher OMERACT scores (p < 0.001) independently predicted moderate-to-high ESSDAI (ESSDAI ≥ 5). No imaging parameter predicted high ESSPRI (ESSPRI ≥ 5) (all p > 0.05); however, USFR was strongly associated with symptom burden (p < 0.001). The final models showed good discrimination (AUC 0.76 for ESSDAI and 0.74 for ESSPRI). SGUS reflects systemic disease activity, whereas SGS has limited clinical value. Patient-reported burden is more closely related to objective salivary hypofunction than to imaging findings. Integrating structural imaging, functional assessment, and patient-reported symptoms in PSD provides complementary information for disease assessment.