title: Usefulness of MR imaging of the parotid glands in patients with secondary Sjögren's syndrome associated with rheumatoid arthritis.
abstract: OBJECTIVE
  To assess the correlation between MR imaging (MRI) of parotid glands with X-ray sialography, histopathology of the labial salivary glands, and salivary secretion, in patients with secondary Sjögren's syndrome (SS) associated with rheumatoid arthritis (RA).
  
  
  METHODS
  Non-contrast MRI of the parotid glands was performed in 13 secondary SS patients associated with RA who satisfied the revised Japanese diagnostic criteria for SS (1999), and the ACR/EULAR classification criteria for RA (2010). The MRI findings were classified according to the degree of high-intensity signal on T1-weighted images (T1WI) and short inversion time inversion recovery (STIR) images into five grades (0-4), using the modified Nagasaki University grading method. The results of MRI grading were compared with the Rubin and Holt staging of X-ray sialography (0-4), the Greenspan grading of labial salivary gland histopathology (0-4), and salivary secretion by the gum test (ml/10 min).
  
  
  RESULTS
  All 13 patients were females, with a mean age of 50.2 ± 11.3 years. According to the MRI grading, 3 patients were Grade 1, 5 were Grade 2, 5 were Grade 3, and none was Grade 0 or Grade 4. The mean stage by X-ray sialography was 1.7 ± 1.0, the mean grade by histopathology was 2.4 ± 1.2, and the mean volume of salivary secretion was 9.7 ± 3.9 ml. The MRI grading correlated significantly with the Rubin and Holt staging and Greenspan grading (P < 0.01 each, Spearman's rank correlation), and significantly and inversely with the results of the gum test (P < 0.05).
  
  
  CONCLUSIONS
  The results suggest that MRI of the parotid glands is a useful noninvasive tool for evaluating destruction and inflammation in the salivary glands.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, University of Tsukuba , Ibaraki , Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yokosawa
authors.forename: Hiroto
authors.initials: H
authors.lastname: Tsuboi
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Nasu
authors.forename: Chihiro
authors.initials: C
authors.lastname: Hagiya
authors.forename: Shinya
authors.initials: S
authors.lastname: Hagiwara
authors.forename: Tomoya
authors.initials: T
authors.lastname: Hirota
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ebe
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Asashima
authors.forename: Yuya
authors.initials: Y
authors.lastname: Kondo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ogishima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Manabu
authors.initials: M
authors.lastname: Minami
authors.forename: Hiroki
authors.initials: H
authors.lastname: Bukawa
authors.forename: Isao
authors.initials: I
authors.lastname: Matsumoto
authors.forename: Takayuki
authors.initials: T
authors.lastname: Sumida
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D010306:Parotid Gland / Q000473:pathology*; D012470:Salivary Glands, Minor / Q000473:pathology; D012472:Salivation; D012796:Sialography; D012859:Sjogren's Syndrome / Q000209:etiology / Q000473:pathology*
keywords: MR imaging; Parotid glands; Rheumatoid arthritis; Sjögren's syndrome