Takashima S, Takeuchi N, Morimoto S, Tomiyama N, Ikezoe J, Shogen K, Kozuka T, Okumura T
Department of Radiology, Osaka University Medical School, Japan.
J Comput Assist Tomogr. 1991 May-Jun;15(3):393-400. doi: 10.1097/00004728-199105000-00009.
Magnetic resonance (MR) imaging of the parotid glands were performed in 13 cases of Sjögren syndrome to assess if there are any typical MR features. The MR findings were compared with sialography and pathology results. Signal intensity ratios of parotid (minus background noise) to skeletal muscle (minus background noise) were measured in these 13 cases as well as in 10 normal controls. Both T1- and T2-weighted images showed multiple hypointense mixed with hyperintense foci (salt-and-pepper appearance) throughout the glands in the six Sjögren cases of intermediate severity (46%), inhomogeneous glands in five cases with early or advanced disease, and homogeneous glands in the remaining two cases with the earliest stage of disease. Mean intensity ratios in T2-weighted pulse sequences in patients with salt-and-pepper appearance and inhomogeneous glands were significantly smaller than those in normal controls (p less than 0.05 and p less than 0.001, respectively). Pathologic studies tend to indicate that focal lymphocytic aggregates associated with increased interlobular fibrosis are probably responsible for the hypointense foci and the decrease in intensity ratios. We think that the salt-and-pepper appearance is suggestive of Sjögren syndrome and that the decreased intensity ratios combined with a typical clinical picture may lead to a highly probable diagnosis of this disorder.
对13例干燥综合征患者的腮腺进行了磁共振（MR）成像检查，以评估是否存在任何典型的MR特征。将MR检查结果与唾液造影和病理结果进行了比较。在这13例患者以及10名正常对照者中测量了腮腺（减去背景噪声）与骨骼肌（减去背景噪声）的信号强度比。在6例中度严重程度的干燥综合征患者（46%）中，T1加权和T2加权图像均显示整个腮腺内有多个低信号灶与高信号灶混合（椒盐样表现）；5例早期或晚期疾病患者的腮腺呈不均匀表现；其余2例疾病最早阶段的患者腮腺呈均匀表现。有椒盐样表现和腮腺不均匀的患者在T2加权脉冲序列中的平均强度比显著低于正常对照者（分别为p<0.05和p<0.001）。病理研究倾向于表明，与小叶间纤维化增加相关的局灶性淋巴细胞聚集可能是低信号灶和强度比降低的原因。我们认为，椒盐样表现提示干燥综合征，强度比降低结合典型的临床表现可能导致对该疾病的高度可能诊断。
