Lacrimal gland ultrasonography shows superior reliability of OMERACT colour Doppler scoring compared to B-mode, in patients with clinically suspected Sjögren's disease.

OBJECTIVE

To investigate the reliability of lacrimal gland ultrasound (LGUS) in patients with clinically suspected Sjögren's disease (SjD).

METHOD: Of 41 consecutive patients with clinically suspected SjD, 28 were diagnosed with SjD and 13 were classified as non-SjD. Forty patients were scored for bilateral lacrimal gland (LG) B-mode evaluation; LGs were 'not visible' in one case. Of these 40, 31 patients also underwent colour Doppler ultrasound (CDUS) evaluation. Images and videos were scored for both LGs using the Hocevar, Outcome Measures in Rheumatology (OMERACT) B-mode, and OMERACT CDUS scoring systems, and scored independently by four blinded observers in two sessions.

RESULTS

For the Hocevar scoring system, intraobserver reliability was fair to moderate, with intraclass correlation coefficients (ICCs) ranging from 0.34 to 0.50. Interobserver reliability was fair, with ICCs of 0.31 and 0.25 between sessions 1 and 2. Individual Hocevar items showed poor to fair interobserver reliability. For the OMERACT B-mode scoring system, intraobserver reliability was fair to moderate, with ICCs ranging from 0.27 to 0.54. Interobserver reliability was poor to fair, with ICCs of 0.23 and 0.16 in sessions 1 and 2. Finally, for OMERACT CDUS, intraobserver reliability was good, with ICCs ranging from 0.61 to 0.80, and interobserver reliability also good, with ICCs of 0.63 and 0.69 in sessions 1 and 2.

CONCLUSION

This study, performing LGUS in patients with clinically suspected SjD, shows that the reliability of B-mode ultrasound may be a concern. The reliability of OMERACT CDUS is superior to Hocevar and OMERACT B-mode scoring of the LGs.