ABSTRACT
Background. Salivary glands ultrasonography (SGUS) is an emerging tool to evaluate damages in primary sjogren patients (pSS). Up to date, SGUS has demonstrated its metric properties as an outcome measure for diagnosing pSS. As New therapeutics protocols are in developing it seems mandatory to use validated SGUS scoring systems. Objectives. The goal of our study was to evaluate international SGUS reliability exercise before beginning an international SGUS study to evaluate Modification Abnormalities of Salivary glands in pSS According to disease duration (MASAI study). Methods. Fourteen sonographers with different levels of SGUS participated in the exercise, evaluating 60 grey scale static images (30 parotid and 30 submandibular glands). Before the exercise, training was done by videoconferencing showing the different pathological SGUS findings and explaining the new OMERACT scoring system. We evaluated homogeneity (yes/no), location of hypoechogenity (0 to 3), hyperechoic band (0-3), comprehensive OMERACT scoring system (0-3), binary comprehensive OMERACT (0-1 versus 2-3) and diagnosis appreciation (No/yes). Intra-reader and interreader reliability were estimated by computing Cohen's kappa coefficients using SPSS 25.0 (SPSS Inc., Chicago, IL), and was interpreted as follows: slight, 0-0.20;fair, 0.21-0.40;moderate, 0.41-0.60;substantial, 0.61-0.80;and almost perfect, 0.81-1. The most experienced sonographer (P4) was considered as the gold standard. Results. Intra-reader reliability of the most experienced was perfect and substantial for the OMERACT scoring system. Intra-reader reliability of the other sonographers was fair to almost perfect for homogeneity and diagnosis whereas the reliability was fair to substantial for other items. Inter-reader reliability between the two most experienced sonographers (P4 and P12) was almost perfect for homogeneity, substantial for diagnosis and moderate for OMERACT scoring system. Changing OMERACT scoring system in binary items, the reliability of the most experienced sonographer was good 0.65 (9 images with homogeneity and low OMERACT, 42 had heterogeneity and high OMERACT, 9 had no homogeneity but low OMERACT and none had homogeneity with high OMERACT), clearly lower that of homogeneity. Compared to the most experienced sonographer, reliabilities of other sonographers were moderate to almost perfect for both homogeneity and diagnosis but only fair to moderate for OMERACT (Table I, II). Conclusions. According to the updated literature, we confirmed that homogeneity is the most reliable item, very close to diagnosis appreciation. Structural damages evaluations by the OMERACT scoring systems gave lower kappa values but remain still useful for diagnosing and particularly following parenchymal modifications. (Table Presented).
ABSTRACT
Acute sialadenitis may be caused by viruses, including coronaviruses. Although there are anecdotal reports of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) salivary gland infections, there have been no well-documented cases of sialadenitis in patients with COVID-19 described in the literature. We report a case of parotitis and submandibular gland sialadenitis, as well as an isolated case of parotitis, in two patients with concurrent SARS-CoV-2 infections. Computed tomography imaging demonstrated parotid and submandibular gland enlargement with heterogenous enhancement and attenuation, consistent with sialadenitis. Medical management was sufficient for successful resolution of the acute sialadenitis. Laryngoscope, 130:2595-2597, 2020.