Goncalves Miguel, Schapher Mirco, Iro Heinrich, Wuest Wolfgang, Mantsopoulos Konstantinos, Koch Michael
Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
Institute of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany.
J Ultrasound Med. 2017 Nov;36(11):2227-2235. doi: 10.1002/jum.14255. Epub 2017 May 27.
The aim of this study was to assess the effectiveness of sonography for diagnosing sialolithiasis in comparison with the existing reference standard of direct identification of a stone.
A total of 659 glands with signs of obstructive sialadenopathy were evaluated retrospectively. Sonographic examinations of the large head salivary glands had been performed initially in all cases. Direct depiction of a stone during sialoendoscopy or transoral ductal surgery or observation of stone fragmentation with discharge of concrements after extracorporeal shock wave lithotripsy, was regarded as definitive evidence and as the reference standard for the presence of sialolithiasis. The sonographic results were compared with those for direct identification of stones.
The sensitivity of sonography was 94.7%, with specificity of 97.4%, a positive predictive value of 99.4%, and a negative predictive value of 79.6%. Stones that were not diagnosed correctly on sonography were most often located in the distal area of the duct.
These results show that sialolithiasis can be diagnosed by sonography with a high degree of certainty. Sonography thus appears to be highly appropriate as the examination method of choice.
本研究旨在评估超声检查诊断涎石病的有效性，并与直接识别结石的现有参考标准进行比较。
回顾性评估659例有阻塞性涎腺病体征的腺体。所有病例均首先对大涎腺进行超声检查。涎腺内镜检查或经口导管手术期间直接观察到结石，或体外冲击波碎石术后观察到结石破碎并排出结石块，被视为确诊依据，并作为涎石病存在的参考标准。将超声检查结果与直接识别结石的结果进行比较。
超声检查的敏感性为94.7%，特异性为97.4%，阳性预测值为99.4%，阴性预测值为79.6%。超声检查未正确诊断的结石最常见于导管远端区域。
这些结果表明，超声检查能够高度准确地诊断涎石病。因此，超声检查似乎是非常合适的首选检查方法。
