Objective Sjögren disease (SjD) is characterized by autoimmune lymphocytic infiltration of lacrimal and salivary glands, leading to dry eye and dry mouth. This study aimed to investigate the features and diagnostic value of lacrimal gland ultrasonography (LGUS) for distinguishing SjD from undifferentiated connective tissue diseases (UCTDs). Methods This prospective cohort study enrolled 80 patients, including 46 with SjD and 34 with non-SjD UCTDs. All participants underwent LGUS, scored according to the OMERACT guidelines for greyscale and color Doppler systems, alongside salivary gland ultrasonography (SGUS) and objective dry eye tests. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis. Results The ocular surface evaluation including tear break-up time (BUT), Schirmer test (ST), ocular staining score (OSS), and LGUS greyscale score of patients with SjD showed significant differences as compared with non-SjD patients, while no difference was found in morphology and color Doppler ultrasound score between the two groups. The ROC of LGUS has an AUC of 0.70 (95% CI 0.579–0.810) compared to other CTD patients; the combined LGUS and SGUS model achieved an AUC of 0.76, while a multivariate nomogram incorporating LGUS, SGUS, Schirmer, and OSS yielded an AUC of 0.792 (95% CI 0.693–0.891). Besides, a significant correlation was found between the LGUS greyscale score and salivary gland involved, anti-SSA antibody, and the ocular surface parameters. Conclusion LGUS is a non-invasive, cost-effective adjunct for early SjD diagnosis. It can be an additional tool integrated with SGUS and clinical tests, substantially improving diagnostic performance. <Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> Key Points • SjD patients showed significantly higher LGUS greyscale score than non-SjD UCTD patients. • LGUS may aid early SjD identification when used alongside ocular surface tests (Schirmer test and ocular staining score), with high specificity (82.4%). • LGUS greyscale score is significantly associated with anti-SSA antibody and parotid greyscale score on SGUS. </entry> </row> </tbody> </tgroup> </Table>

Lacrimal gland ultrasonography as an adjunct tool for Sjögren disease (SjD) diagnosis from undifferentiated connective tissue diseases

期刊论文
发表日期：

2026年3月21日

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Chang Liu,
Wenyan Zhou,
Zhongqiang Yao,
Haozhe Yu,
Bo Yang,
Jingyi Li,
Shumin Wang,
Yun Feng

摘要

Objective

Sjögren disease (SjD) is characterized by autoimmune lymphocytic infiltration of lacrimal and salivary glands, leading to dry eye and dry mouth. This study aimed to investigate the features and diagnostic value of lacrimal gland ultrasonography (LGUS) for distinguishing SjD from undifferentiated connective tissue diseases (UCTDs).

Methods

This prospective cohort study enrolled 80 patients, including 46 with SjD and 34 with non-SjD UCTDs. All participants underwent LGUS, scored according to the OMERACT guidelines for greyscale and color Doppler systems, alongside salivary gland ultrasonography (SGUS) and objective dry eye tests. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis.

Results

The ocular surface evaluation including tear break-up time (BUT), Schirmer test (ST), ocular staining score (OSS), and LGUS greyscale score of patients with SjD showed significant differences as compared with non-SjD patients, while no difference was found in morphology and color Doppler ultrasound score between the two groups. The ROC of LGUS has an AUC of 0.70 (95% CI 0.579–0.810) compared to other CTD patients; the combined LGUS and SGUS model achieved an AUC of 0.76, while a multivariate nomogram incorporating LGUS, SGUS, Schirmer, and OSS yielded an AUC of 0.792 (95% CI 0.693–0.891). Besides, a significant correlation was found between the LGUS greyscale score and salivary gland involved, anti-SSA antibody, and the ocular surface parameters.

Conclusion

LGUS is a non-invasive, cost-effective adjunct for early SjD diagnosis. It can be an additional tool integrated with SGUS and clinical tests, substantially improving diagnostic performance.

Key Points

• SjD patients showed significantly higher LGUS greyscale score than non-SjD UCTD patients.

• LGUS may aid early SjD identification when used alongside ocular surface tests (Schirmer test and ocular staining score), with high specificity (82.4%).

• LGUS greyscale score is significantly associated with anti-SSA antibody and parotid greyscale score on SGUS.