超声筛查唾液腺的影响
Impact of Screening for Salivary Gland by Ultrasonography.
作者信息
Onda Kanna, Fukuhara Takahiro, Matsuda Eriko, Donishi Ryohei, Hirooka Yasuaki, Takeuchi Hiromi, Kato Masahiko
机构信息
Department of Pathobiological Science and Technology, School of Health Science, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
出版信息
Yonago Acta Med. 2020 Jan 30;63(1):42-46. doi: 10.33160/yam.2020.02.006. eCollection 2020 Feb.
BACKGROUND
Ultrasonography is superior to other imaging modalities for detecting salivary gland diseases. However, there have been no reports of the results of salivary gland screening with ultrasonography. In this study, the salivary glands were also observed during thyroid ultrasonography to determine the degree of salivary gland abnormalities detected by ultrasonography.
METHODS
This study was conducted retrospectively using medical records. It assessed the association between the following abnormal findings detected during thyroid ultrasonography and their final diagnoses: atrophy/swelling, unclear demarcation from surrounding tissues, decreased salivary gland parenchyma echo level, heterogeneity of parenchyma, hypervascularity of salivary gland parenchyma, dilatation of the ducts, and a mass within the gland.
RESULTS
Of the 908 patients who underwent thyroid ultrasonography, salivary gland abnormalities were detected in 36 (4.0%) patients. Of the 36 patients with abnormal ultrasonographic findings, 22 underwent further examination. Of the 22 patients, 16 received definitive diagnoses of salivary gland diseases.
UNLABELLED
Salivary gland disorders were considered to be absent in patients with only heterogeneity of the salivary glands observed on ultrasonography. Salivary gland disorders in all patients with further abnormal ultrasonographic findings such as atrophy/swelling, unclear boundary, or hypervascularity in addition to internal heterogeneity were confirmed by further blood examinations and imaging studies. We were able to detect autoimmune sialadenitis such as Sjögren's syndrome and IgG4-related sialadenitis by ultrasonography in patients without obvious symptoms.
CONCLUSION
Salivary gland screening during thyroid ultrasonography revealed abnormal findings including Sjögren's syndrome and IgG4-related sialadenitis in about 4% of the patients. Thus, ultrasonography may also be useful for early detection of autoimmune diseases of salivary glands.
背景
超声检查在检测唾液腺疾病方面优于其他成像方式。然而，尚无关于超声检查进行唾液腺筛查结果的报道。在本研究中，甲状腺超声检查时也对唾液腺进行了观察，以确定超声检查所发现的唾液腺异常程度。
方法
本研究采用病历进行回顾性研究。评估甲状腺超声检查期间发现的以下异常表现与其最终诊断之间的关联：萎缩/肿胀、与周围组织分界不清、唾液腺实质回声水平降低、实质异质性、唾液腺实质血管增多、导管扩张以及腺体内肿块。
结果
在接受甲状腺超声检查的908例患者中，36例（4.0%）发现唾液腺异常。在36例超声检查结果异常的患者中，22例接受了进一步检查。在这22例患者中，16例得到了唾液腺疾病的确切诊断。
未标记
仅超声检查发现唾液腺异质性的患者被认为不存在唾液腺疾病。所有超声检查有进一步异常表现（如萎缩/肿胀、边界不清或除内部异质性外血管增多）的患者，通过进一步的血液检查和影像学研究确诊为唾液腺疾病。我们能够通过超声检查在无明显症状的患者中检测出自身免疫性涎腺炎，如干燥综合征和IgG4相关性涎腺炎。
结论
甲状腺超声检查期间的唾液腺筛查发现约4%的患者存在包括干燥综合征和IgG4相关性涎腺炎在内的异常表现。因此，超声检查也可能有助于唾液腺自身免疫性疾病的早期检测。
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