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超声检查及彩色多普勒超声检查在涎腺疾病诊断中的应用价值

[Usefulness of ultrasonography and color Doppler sonography in the diagnosis of major salivary gland diseases].

作者信息

Salaffi F, Carotti M, Argalia G, Salera D, Giuseppetti G M, Grassi W

机构信息

Dipartimento di Patologia Molecolare e Terapie Innovative, Cattedra di Reumatologia, Università Politecnica delle Marche, Jesi, Ancona.

出版信息

Reumatismo. 2006 Apr-Jun;58(2):138-56. doi: 10.4081/reumatismo.2006.138.

Abstract

The algorithm for imaging of the salivary glands depends on the clinical scenario with which the patient presents to the clinician. Ultrasound has been increasingly used in recent years and thanks to high performance, easy to use apparatus, it can now be used for exploration of the salivary glands. This non invasive, painless and relatively inexpensive examination provides rapid visualisation of the salivary glands and is a useful adjunct to computed tomography and magnetic risonance imaging examination, particularly in tumour pathology. In recent years, publications have highlighted the potential uselfulness of salivary gland ultrasonography as a simple and non-invasive adjunctive test for the detection of gland involvement in Sjögren's syndrome (SS). SS is a chronic inflammatory disease of the salivary glands characterised by focal lymphocytic infiltrates that cause progressive destruction of the acinar structures. The findings of a previous study lead us to believe, in agreement with other examiners, that semiquantitative assessment of ultrasonographic images of the salivary glands is a sensitive and very useful means of evaluating salivary involvement in SS. Color Doppler sonography is a recently introduced method which makes it possible to evaluate intra- and perilesional vascularization and to perform a hemodynamic study of the area being explored. The color Doppler sonography can provide a useful adjunct to conventional ultrasound, increasing diagnostic accuracy in submandibular- parotid masses and to analyze physiologic changes that occur during salivary stimulation in normal subjects and the flow alterations that occur in diseased glands of SS patients. This article reviews the normal ultrasound anatomy of the salivary glands along with lithiasic, inflammatory, tumoral, and autoimmune disease such as SS.

摘要

唾液腺成像算法取决于患者向临床医生呈现的临床情况。近年来,超声检查的应用越来越广泛,得益于高性能、易于使用的设备,现在它可用于唾液腺的探查。这种非侵入性、无痛且相对便宜的检查能快速呈现唾液腺图像,是计算机断层扫描和磁共振成像检查的有益辅助手段,尤其在肿瘤病理学方面。近年来,一些出版物强调了唾液腺超声检查作为一种简单且非侵入性的辅助检查,在检测干燥综合征(SS)患者腺体受累情况方面的潜在有用性。SS是一种唾液腺的慢性炎症性疾病,其特征是局灶性淋巴细胞浸润,导致腺泡结构逐渐破坏。一项先前研究的结果使我们与其他检查者一致认为,对唾液腺超声图像进行半定量评估是评估SS患者唾液腺受累情况的一种敏感且非常有用的方法。彩色多普勒超声检查是一种最近引入的方法,它能够评估病变内部及周围的血管形成情况,并对所探查区域进行血流动力学研究。彩色多普勒超声检查可为传统超声检查提供有用的辅助,提高对颌下腺 - 腮腺肿块的诊断准确性,并分析正常受试者唾液刺激期间发生的生理变化以及SS患者患病腺体中出现的血流改变。本文回顾了唾液腺的正常超声解剖结构,以及结石、炎症、肿瘤和自身免疫性疾病(如SS)的情况。

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