Schäfer V S, Schmidt W A
Innere Medizin, Rheumatologie und Klinische Immunologie, Standort Berlin-Buch, Immanuel Krankenhaus Berlin, Lindenberger Weg 19, 13125, Berlin, Deutschland.
Z Rheumatol. 2017 Sep;76(7):589-594. doi: 10.1007/s00393-017-0305-5.
Ultrasound of the salivary glands is a specific examination for detecting pathology of salivary glands in the diagnosis of Sjögren's syndrome. It is easy to learn, rapidly performed, non-invasive and inexpensive. Other imaging techniques, such as sialography and scintigraphy, are currently only rarely performed. For the examination, linear ultrasound probes with frequencies between 7 and 12 MHz are recommended. Such probes are already widely available to the rheumatologist performing musculoskeletal ultrasound. The parotid and submandibular glands are bilaterally scanned both in longitudinal and transverse planes as a standard.Normal salivary glands have uniformly hyperechoic and homogeneous tissue. They can be clearly delineated from the surrounding muscles and soft tissue and appear similar to the thyroid gland. The salivary glands are typically hypoechoic and inhomogeneous in Sjögren's syndrome. Focal or diffuse hypoechoic or anechoic foci are found in the glands. The submandibular glands may become atrophic (sagittal diameter <8 mm). Particularly in disease flares, the parotid glands may become enlarged (sagittal diameter >20 mm). The sensitivity for the diagnosis is 60 to 90% and the specificity is over 90%.Doppler sonography does not further improve the diagnostic accuracy. Sonography has thus become an important tool in the diagnosis of Sjögren's syndrome.
唾液腺超声是干燥综合征诊断中检测唾液腺病变的一项特异性检查。它易于学习，检查快速，无创且费用低廉。目前，诸如唾液腺造影和闪烁扫描等其他成像技术很少使用。对于该检查，建议使用频率在7至12兆赫兹之间的线性超声探头。进行肌肉骨骼超声检查的风湿病学家已经广泛使用此类探头。作为标准操作，需在纵切面和横切面上对双侧腮腺和颌下腺进行扫描。正常唾液腺组织呈均匀高回声且质地均匀。它们可与周围肌肉和软组织清晰区分，外观与甲状腺相似。在干燥综合征中，唾液腺通常呈低回声且不均匀。腺体内可发现局灶性或弥漫性低回声或无回声灶。颌下腺可能会萎缩（矢状径<8毫米）。特别是在疾病发作期，腮腺可能会肿大（矢状径>20毫米）。诊断的敏感性为60%至90%，特异性超过90%。多普勒超声检查并不能进一步提高诊断准确性。因此，超声检查已成为干燥综合征诊断中的一项重要工具。
