Evaluation of lacrimal gland vascularisation using superb microvascular imaging: a potential diagnostic tool in Sjögren's syndrome.

Objectives: To evaluate the superior microvascular imaging (SMI) findings of the lacrimal glands for the sonographic diagnosis of primary Sjögren's syndrome (pSS).

Methods: 21 patients with pSS and 20 healthy groups were evaluated. Dry eye symptoms and their effects on vision-related functions were evaluated with McMonnies and Ocular Surface Disease Index (OSDI) questionnaires. Lacrimal glands were evaluated by power Doppler ultrasonography (PDUS), colour Doppler ultrasonography (CDUS) and SMI. The diagnostic accuracy of SMI was compared using these techniques.

Results: Dry eye symptoms, as determined by McMonnies and OSDI, were significantly more severe in patients with pSS than in control group (p=0.001 and p=0.021, respectively). Lacrimal gland vascular activity rates and hypoechoic areas were significantly higher in pSS patients compared to the control group (p<0.05). It was observed that the detection rates of inflammatory activity in patients with SMI were higher than CDUS and PDUS. In ROC analysis, the SMI technique has the highest accuracy in predicting the probability of pSS in the lacrimal gland compared to the others. In addition, SMI was positively correlated with CDUS, PDUS, OSDI and McMonnies (r=0.809, p<0.001; r=0.773, p<0.001; r=0.756, p=<0.001; r=0.351, p=0.021 respectively).

Conclusion: Evaluation of the lacrimal gland by the SMI was found to be excellent in predicting the likelihood of individuals having pSS compared to CDUS and PDUS. This technique may have a role as a reliable and non-invasive adjunctive tool to assess the degree of lacrimal vascularity in pSS.