OBJECTIVE: To assess the construct validity of the novel Outcome Measures in Rheumatology (OMERACT) ultrasound (US) semiquantitative scoring system for morphological lesions in major salivary glands by comparing it with magnetic resonance imaging (MRI) and unstimulated whole salivary flow rates (U-WSFRs) in patients with primary Sjögren syndrome (pSS). METHODS: Nine sonographers applied the OMERACT 0-3 grayscale scoring system for parotid (PGs) and submandibular glands (SMGs) in 11 patients with pSS who also had MRIs performed. These were evaluated by 2 radiologists using a semiquantitative 0-3 scoring system for morphological lesions. The agreement between US and MRI and the association between U-WSFRs and imaging structural lesions was determined. A score ≥ 2 for both US and MRI was defined as gland pathology. RESULTS: The prevalence of US morphological lesions in 11 patients with a score ≥ 2 was 58% for PGs and 76% for SMGs, and 46% and 41% for PGs and SMGs, respectively, for MRI. The agreement between OMERACT US scores and MRI scores was 73-91% (median 82%) in the right PG and 73-91% (median 91%) in the left PG, 55-91% (median 55%) in the right SMG and 55-82% (median 55%) in the left SMG. When relations between the presence of hyposalivation and an US score ≥ 2 were examined, agreement was 91-100% (median 83%) in both PGs and 55-91% (median 67%) in both SMGs. CONCLUSION: There is moderate to strong agreement between the OMERACT US and MRI scores for major salivary glands in patients with pSS. Similar agreement ratios were observed between the higher OMERACT US scores and presence of hyposalivation.

A Hocevar MD PhD Rheumatology Department University Medical Centre Ljubljana Slovenia

A Iagnocco MD Academic Rheumatology Centre Università degli Studi di Torino Turin Italy

Ç Cimşit MD C Cimşit MD Radiology Department Marmara University School of Medicine Istanbul Turkey

C Pineda MD PhD Rheumatology Department Instituto Nacional de Rehabilitacion Mexico City Mexico

E Naredo MD PhD Rheumatology Department Joint and Bone Research Unit Hospital Universitario Fundación Jiménez Díaz Universidad Autónoma Madrid Spain

G A Bruyn MD PhD Rheumatology Reumakliniek Lelystad Lelystad and Tergooi MC Hospitals Hilversum the Netherlands

G Mumcu DDS PhD Department of Health Management Faculty of Health Sciences Marmara University Istanbul Turkey

H Keen MD Medicine and Pharmacology Department The University of Western Australia Murdoch Perth Australia

L Terslev PhD Centre for Rheumatology and Spine Diseases Rigshospitalet Copenhagen Denmark

M A D'Agostino MD PhD Hôpital Ambroise Paré Boulogne Billancourt Versailles Saint Quentin University Versailles France

N Inanc MD K Abacar MD Rheumatology Department Marmara University School of Medicine Istanbul Turkey

N Inanc MD K Abacar MD Rheumatology Department Marmara University School of Medicine Istanbul Turkey;

P Hanova MUDr Rheumatology 1st Faculty of Medicine Charles University Prague Czech Republic

S Finzel MD Department of Rheumatology and Clinical Immunology Medical Center University of Freiburg Faculty of Medicine University of Freiburg Freiburg Germany

S Jousse Joulin MD CHU de Brest University Brest Inserm LBAI UMR 1227 Brest France

W A Schmidt MD Immanuel Krankenhaus Berlin Medical Center for Rheumatology Berlin Buch Berlin Germany

References provided by Crossref.org