MR features of the lacrimal gland in Sjögren's syndrome

Our purpose was to investigate the MR features of the lacrimal glands in patients with Sjögren's syndrome.

Using MR imaging, we examined 58 lacrimal glands in 29 women with Sjögren's syndrome and 150 lacrimal glands in 75 female control subjects. The patients ranged in age from 21 to 76 years, and the control subjects ranged in age from 0 to 78 years. We analyzed the thicknesses and internal signal intensity patterns of the lacrimal glands and compared the results with lacrimal flow rates using Schirmer's test.

On the basis of the profile of normal age-related decreases in lacrimal gland thickness that we obtained from our control subjects, we categorized the lacrimal glands in the patients with Sjögren's syndrome as hypertrophic (7.8 +/- 0.8 mm), normal-sized (4.8 +/- 1.2 mm), or atrophic (2.4 +/- 0.5 mm). The patients had slower lacrimal flow rates than did the control subjects. Atrophic lacrimal glands had slower lacrimal flow rates (1.8 +/- 1.2 mm/5 min) than did normal-sized (5.2 +/- 2.8 mm/5 min) and hypertrophic (4.3 +/- 2.6 mm/5 min) glands. Normal-sized lacrimal glands with homogeneous MR features had faster lacrimal flow rates (7.6 +/- 2.2 mm/5 min) than did normal-sized glands with heterogeneous MR features (4.0 +/- 2.4 mm/5 min). Fat suppression studies showed that fat deposition was accelerated in the lacrimal glands of patients with Sjögren's syndrome.

These results suggest that change in size associated with accelerated fat deposition may be the characteristic MR feature of lacrimal glands affected by Sjögren's syndrome. Thus, MR imaging could be a useful tool for assessment of the extent of lacrimal gland involvement in patients with Sjögren's syndrome.