Shear wave elastography of the salivary glands in the diagnosis of Sjögren disease: a systematic review and meta-analysis.

OBJECTIVE

Sjögren disease (SD) is characterized by lymphocytic infiltration and fibrosis of the salivary glands. Shear wave elastography (SWE), an ultrasound-based modality that quantifies tissue stiffness, may assist in SD diagnosis. This study aimed to systematically review and meta-analyze the diagnostic performance of SWE in evaluating major salivary glands in individuals with SD, based on studies applying the 2016 ACR/EULAR classification criteria.

METHODS

Six electronic databases and gray literature sources were searched. Cross-sectional and diagnostic accuracy studies were included. Risk of bias was appraised using the Joanna Briggs Institute tool. Quantitative synthesis was performed using random-effects meta-analyses.

RESULTS

Eleven studies comprising 1029 participants (530 with SD; 499 controls; 90.67% female) were included. Meta-analyses revealed that SWE values were significantly higher in SD patients than in controls, with pooled mean differences of 0.78 m/s (95% CI: 0.54-1.02) and 12.37 kPa (95% CI: 8.65-16.10) in the parotid gland, and 0.48 m/s (95% CI: 0.33-0.63) and 9.09 kPa (95% CI: 4.88-13.31) in the submandibular gland. Parotid SWE values expressed in kPa showed the highest diagnostic accuracy (AUC = 82.9%), followed by values in m/s (AUC = 73.1%).

CONCLUSIONS

SWE effectively differentiates SD from healthy individuals, particularly when applied to the parotid gland. Standardization of SWE protocols may enhance diagnostic accuracy and foster clinical integration.

ADVANCES IN KNOWLEDGE: This is the first meta-analysis focused exclusively on studies adopting the 2016 ACR/EULAR criteria for SD.