Falkowski A
II Zakładu Diagnostyki Rentgenowskiej Instytutu Radiologii Pomorskiej Akademii Medycznej w Szczecinie.
Ann Acad Med Stetin. 1998;44:209-21.
The aim of the study was to evaluate usefulness of colour Doppler ultrasound examination in diagnosing the salivary gland tumours and the metastatic tumours of the neck originating from the facial part of the skull. Epidemiology and histopathology of the neoplasms involving the salivary glands and the facial skeleton were discussed including the route of their spreading to the neck. The author presents update techniques of bony face radiologic imaging and basic principles of modern colour Doppler ultrasound. The examinations with the use of a colour Doppler equipment-Acuson 128-XP 10 were performed in 150 patients with the neck tumours. The exact location, size, morphology and blood supply were assessed using B and B colour mode. Then some big neck vessels like the common, internal and external carotid artery, vertebral artery, internal jugular vein were visualized. All the patients were divided into three groups according to what they were suffering from: sialoadenitis, benign and malignant tumours. The obtained results were compared and confronted with clinical features. The pattern of vascularization failed to allow for establishing preliminary diagnosis in patients in each group. Within the first group, with inflamed glands did not compress the neck vessels. Of all the patients with benign tumours, extrinsic compression on the internal jugular vein and the carotid arteries was found in 16 and 14 patients respectively. In the third group of patients with malignant disease, compression on the veins was detected in 10 cases while 5 tumours compressed the arteries. The invasion involved the internal jugular vein in 7 patients while the common and internal carotid arteries were invaded in 6. The vertebral artery was never found to be affected. It was demonstrated that compression on veins resulted in disturbing the flow which was not observed as far as the arteries were concerned. Disturbing in the flow of veins and arteries was disclosed in cases of invasion. Atheromatosis was detected in patients of each group, 7 of them had to be operated on due to a stricture within the proximal part of internal carotid artery. The results of the study express high diagnostic value of colour Doppler ultrasound examination in the neck tumours. The examination should be obligatory performed as one of the first diagnostic measures after admitting a patient. The method seems to be of very little use in diagnosis differentiating inflammation, benign and malignant salivary gland tumours and metastatic masses of the neck hence some other diagnostic procedures should be here employed.
本研究的目的是评估彩色多普勒超声检查在诊断涎腺肿瘤以及起源于颅骨面部部分的颈部转移性肿瘤中的作用。讨论了涉及涎腺和面部骨骼的肿瘤的流行病学和组织病理学，包括它们扩散至颈部的途径。作者介绍了面部骨骼放射成像的最新技术以及现代彩色多普勒超声的基本原理。使用彩色多普勒设备——Acuson 128-XP 10对150例颈部肿瘤患者进行了检查。采用B型和B彩色模式评估肿瘤的确切位置、大小、形态和血供。然后观察了一些颈部大血管，如颈总动脉、颈内动脉、颈外动脉、椎动脉和颈内静脉。所有患者根据所患疾病分为三组：涎腺炎、良性肿瘤和恶性肿瘤。将获得的结果与临床特征进行比较和对照。血管化模式无法在每组患者中进行初步诊断。在第一组中，腺体发炎未压迫颈部血管。在所有良性肿瘤患者中，分别有16例和14例发现颈内静脉和颈动脉受到外部压迫。在第三组恶性疾病患者中，10例检测到静脉受压，5例肿瘤压迫动脉。7例患者的侵袭累及颈内静脉，6例患者的颈总动脉和颈内动脉受到侵袭。从未发现椎动脉受影响。结果表明，静脉受压会导致血流紊乱，而动脉方面未观察到这种情况。侵袭病例中发现静脉和动脉血流紊乱。每组患者均检测到动脉粥样硬化，其中7例因颈内动脉近端狭窄而接受手术。研究结果表明彩色多普勒超声检查对颈部肿瘤具有较高的诊断价值。该检查应作为患者入院后的首批诊断措施之一常规进行。该方法在区分炎症、良性和恶性涎腺肿瘤以及颈部转移性肿块的诊断中似乎作用不大，因此应采用其他一些诊断程序。
