高频超声观察干燥综合征患者泪腺、涎腺的临床价值

目的:探讨高频超声观察干燥综合症患者泪腺、腮腺、颌下腺的临床价值。方法:对11例确诊为干燥综合征及可疑干燥综合征的患者,利用高频超声观察其腮腺、颌下腺、泪腺的超声声像图特征并进行总结。结果:7例确诊为干燥综合征患者的腺体均有不同程度的超声改变,2例可疑为干燥综合征患者的腺体亦有不同程度的超声表现。结论:干燥综合征患者的腮腺、颌下腺、泪腺均有不同程度的超声改变,高频超声对于干燥综合征患者的辅助诊断有一定的临床价值。     

涎腺肿瘤的超声诊断

目的分析涎腺肿瘤的声像图特征，以提高超声定性诊断正确率。方法回顾分析62例经手术病理证实的涎腺肿瘤的超声声像图特征。结果超声定性诊断正确率仅40．3％。经手术病理证实的良性肿瘤以多形性腺瘤和腺淋巴瘤为主，声像图具有特征性。结论超声检查对涎腺多形性腺瘤和腺淋巴瘤有较大的诊断价值，但对部分较小的恶性肿瘤和良性肿瘤局部恶变者诊断缺乏特征性，是导致定性困难和误诊的主要原因。     

涎腺黏液表皮样癌的超声研究

目的分析涎腺黏液表皮样癌的声像图特点,进一步细化研究涎腺恶性肿瘤的超声表现。方法对25例涎腺黏液表皮样癌的声像图作综合观察,结合病理提示肿瘤的恶性程度总结分析。结果13例(52%)境界不清晰,16例(64%)形态不规则,19例(76%)回声不均匀,3例(12%)同侧颈深上淋巴结转移。根据涎腺黏液表皮样癌的恶性程度不同其超声表现可分为三型:(1)类良性型;(2)典型恶性型;(3)交界瘤型。低度恶性涎腺黏液表皮样癌的超声误诊率较高。结论涎腺黏液表皮样癌具有涎腺恶性肿瘤常见的声像图表现,但是仍存在本病较为独有的特点。超声可作出较为准确的诊断,是一种有效的检查方法。     

涎腺疾病灰阶超声诊断

目的 探讨灰阶超声对涎腺疾病的诊断价值,分析各类疾病的声像图特点。方法 回顾分析54例经病理证实的涎腺疾病的灰阶超声声像图。结果 灰阶超声鉴别涎腺囊、实性病变准确性较高,囊肿诊断准确率100％;混合瘤和腺淋巴瘤可根据肿块形态,内部及后方回声,病灶个数等方面进行鉴别;恶性肿瘤的声像图与良性肿瘤比较,缺乏一定特征,鉴别尚有一定困难,结合临床资料有一定帮助。涎腺弥漫性炎症根据腺体内部回声及肿块无明显边界诊断容易,涎腺导管结石诊断可靠。涎腺淋巴结炎症或结核为多发、边界清晰的低回声光团。结论 灰阶超声对良性病变有较好的鉴别价值,对良、恶性肿瘤鉴别尚有一定困难,结合临床表现有助超诊断。     

彩色多普勒超声诊断涎腺肿块

目的探讨涎腺肿块高频声像图特点,并评价CDFI对涎腺肿块的应用价值,旨在不断提高诊断符合率。方法用CDFI对48例涎腺肿块患者的声像图进行对比分析。结果显示恶性肿块的血流信号检出率高,良、恶性肿块的血流信号检出率分别为33.3%(11/33)、73.3%(11/15)。两者有显著性差异。结论高频超声能确定腺体内是否有占位性病变,而CDFI对涎腺肿块的囊、实性和良、恶性诊断及鉴别诊断具有重要参考价值。     

原发性干燥综合征的涎腺超声表现及其在诊断中的价值

目的分析原发性干燥综合征的涎腺超声表现及其在诊断和鉴别诊断中的作用。方法选择2011年5月至2012年4月35例确诊的原发性干燥综合征患者为病例组(22例早期组,13例中晚期组),选择非干燥综合征患者30例为对照组。均进行涎腺超声检查及Schirmer试验、抗SSA/SSB抗体、角膜荧光素染色等实验室检查。观察二维图像特征、涎腺大小、涎腺血流动力学参数,比较涎腺超声检查与三种实验室检查的诊断效能。结果病例组35例中,30例弥漫性改变,5例为局限性改变,腮腺或颌下腺病区低回声数目明显多于对照组。腮腺、颌下腺上下径、左右径和体积呈现早期组>对照组>中晚期组,差异有统计学意义(P均<0.05);早期组腮腺收缩期峰值血流速度(PSV)、颌下腺PSV明显高于对照组(P均<0.05);中晚期组PSV、舒张末期血流速度(EDV)明显低于对照组(P均<0.05)。涎腺超声对原发性干燥综合征诊断的灵敏度(80.00%)、特异度(93.33%)、准确率(86.15%)、阳性预测值(93.33%)、阴性预测值(80.00%)较Schimer试验(71.43%、83.33%、76.92%、83.33%、71.43%)和角膜染色(74.29%、86.67%、80.00%、86.67%、74.29%)均有所提高;而与抗SSA/SSB相当。结论超声可清晰观察涎腺实质回声、腺体大小、血流变化,具有较高的诊断效能,可作为鉴别诊断干燥综合征的首选方法。     

涎腺肿瘤的声像图特征与病理对照分析

本文总结了经手术与病理证实的５０例涎腺肿瘤的声像图特征，并与病理组织结构进行对照，探讨肿瘤的超声特征与病理改变的关系，旨在提高涎腺肿瘤的诊断符合率。本组男２２例，女２８例，年龄在１９～５５岁，腮腺４２例，颌下腺８例。多形性腺瘤３３例，腺淋巴瘤１１例，...     

超声诊断涎腺腺样囊性癌

目的 探讨涎腺腺样囊性癌的声像图特点。 方法 结合病理特征,对经手术病理证实的36例涎腺腺样囊性癌的声像图表现进行回顾性分析。 结果 36例涎腺腺样囊性癌均为单发,实质呈低回声,其中22例(22/36,61.11%)肿瘤形态不规则,21例(21/36,58.33%)肿瘤边界不清,28例(28/36,77.78%)病灶内部回声不均匀,肿瘤血流信号少量及中等量各15例(15/36,41.67%)。超声定性诊断为恶性肿瘤的符合率为58.33%(21/36)。 结论 腺样囊性癌具有涎腺恶性肿瘤常见的灰阶声像表现,但彩色多普勒表现具有特征性。超声检查结合临床表现有助于正确诊断。     

二维及彩色多普勒超声对涎腺肿块的诊断价值

目的：探讨二维及彩色多普勒超声对涎腺肿块的诊断价值。方法：收集应用二维及彩色多普勒超声诊断的涎腺肿块32例。良性肿块24例，恶性肿块8例，所有病例均经手术及病理证实。结果：2D及CDFI联合使用，对病灶的检出率为100％，其准确性为84.4%（27／32）。结论：涎腺肿块的超声诊断应以二维声像图为基础，同时密切结合肿块的血流信号丰富程度。2D及CDFI联合应用，在涎腺肿块的鉴别诊断中有较高的诊断价值。     

超声对腺性膀胱炎诊断与分型价值的探讨

目的探讨腺性膀胱炎的超声影像特征，以提高识别该病的能力。方法对２６例经腹超声首先检出的腺性膀胱炎声像图表现进行总结分析。结果２６例腺性膀胱炎定位诊断符合率１００％，定性符合率８０．７７％。结合病理变化将该病的声像图表现分为３型：Ⅰ型，结节隆起型；Ⅱ型，局部壁厚型；Ⅲ型，全壁厚增型。结论腺性膀胱炎有较典型的声像图特征者，多能确定诊断。超声对膀胱隆起性病变在某些方面优于膀胱镜和其他影像学检查，应作为对     

Comparative sonographic, x-ray and morphological studies of the salivary glands in Sj?gren's syndrome]

AIM: To define diagnostic value of parotid gland (PG) sonography in Sjogren's syndrome (SS) as compared to sialography and morphological changes of labial salivary glands (LSG). MATERIALS AND METHODS: Examination of 50 females with primary (20 patients) and secondary (30 patients) SS consisted of clinical, ultrasonic, x-ray and morphological investigations. RESULTS: Sonographically, PG in SS is characterized by nonhomogeneity of parenchymal picture detected in 75% of patients with primary and 50% of patients with secondary SS. Moderate and severe nonhomogeneity of PG parenchyma was seen in the stage of marked manifestations of chronic parenchymatous parotitis. CONCLUSION: Relationship between PG sonographic image in SS and morphological changes in LSG need further study. PG sonography may help in combined examination of SS patients.     

Salivary gland mucosa-associated lymphoid tissue lymphoma in 2 patients with Sjögren's syndrome: clinical and sonographic features with pathological correlation

We report 2 cases of mucosa-associated lymphoid tissue lymphoma of the salivary glands, complicating Sj?gren's syndrome. The sonographic and histological features are described in depth. The use of sonography as a diagnostic aid in such patients is discussed.     

Sonography of lacrimal glands in Sjögren syndrome.

This study evaluates the potential role of high resolution sonography and color Doppler sonography in the evaluation of the lacrimal glands in Sjögren syndrome. We examined 15 women (age range, 52‐73 years) affected by Sjögren syndrome and 15 women with no history and signs of lacrimal disease (age range, 47‐75 years). The lacrimal glands were visualized bilaterally in 6 of 15 patients. The lacrimal artery was detectable in all patients; the resistive index was higher than normal (0.72±0.04). An abnormal Schirmer test was present in six of six patients with visible glands and in two of nine patients with invisible glands; xerophthalmia was present in six of six patients with visible glands and in four of nine patients with invisible glands; high levels of serum immunoglobulins were present in six of six patients with visible glands and in three of nine patients with invisible glands. Sonography is able to provide noninvasively much of the information needed by the clinician.     

Sjögren syndrome: A case report

Sjögren syndrome is a systemic autoimmune disorder that affects the exocrine glands. The authors present the case of a 50-year-old woman diagnosed with this syndrome on the basis of clinical and serological findings. Sonography of the major salivary glands revealed normal-sized glands with echo structures that were diffusely inhomogeneous due to the presence of multiple hypoechoic areas. Parenchymal vascularization was significantly increased on color Doppler imaging. These findings confirmed the diagnosis and revealed active disease manifested by glandular hypervascularization. This represents a typical case of Sjögren syndrome and illustrates the diagnostic value in these cases of salivary gland sonography, which is effective, noninvasive, and repeatable and provides accurate information on the vascularization status of the glands.     

Sonographic detection of secondary MALT lymphoma of the submandibular gland.

This report describes a case of mucosa-associated lymphoid tissue (MALT) lymphoma of the lacrimal glands that recurred in the submandibular salivary glands. Gray-scale sonography showed small hypoechoic nodules, measuring less than 0.5 cm in diameter, in both submandibular glands. The echogenicity and echotexture of the rest of the submandibular glands and of the parotid glands was normal. Power Doppler sonography revealed increased vascularity within the nodules. A sonographically guided aspiration biopsy of the nodules revealed MALT lymphoma. Secondary MALT lymphoma should be considered in the presence of multiple small hypoechoic nodules in the salivary glands in patients with a history of MALT lymphoma at another location.     

Vascular endothelium and lymphocyte adhesion molecules in minor salivary glands of patients with Sjogren's syndrome.

The aim of this study was to examine the distribution and types of adhesion molecules expressed over endothelial cells and the ligands present on lymphocytes which infiltrate exocrine glands in patients with Sjogren's syndrome. Minor salivary gland biopsies were examined from twelve patients with Sjogren's syndrome and eight normal subjects for the presence of adhesion molecules using monoclonal antibodies and an Indirect Immunoperoxidase technique. There was an increased expression of intercellular adhesion molecule-1 (ICAM-1, CD54) on endothelial cells, lymphocytes, fibroblasts and salivary gland epithelial cells. In addition we documented the expression of endothelial leukocyte adhesion molecule-1 (ELAM-1) on endothelial cells in salivary glands from patients but not the controls. Many of the endothelial cells expressing these adhesion molecules in patients with Sjogren's syndrome had the morphological appearance of high endothelial venules. V-CAM-1 was shown to be present in some of the salivary biopsies from patients with Sjogren's syndrome. Lymphocytes infiltrating salivary glands strongly express LFA-1 (CD11a/CD18) molecules. Some infiltrating lymphocytes, and most monocytes, expressed C3bi-R (CD11b/CD18) and the p150.95 (CD11c/CD18) antigens on their cell surface. The results of this study reveal the enhanced expression of vascular endothelial and lymphocyte adhesion molecules on the minor salivary glands of patients with Sjogren's syndrome. The presence of such receptors and their putative ligands indicate an important role for these molecules in the pathogenesis of Sjogren's syndrome.     

Sonographic appearances of malignant lymphoma of the salivary glands.

PURPOSE: We undertook this retrospective study to describe the sonographic findings in patients with malignant lymphoma of the major salivary glands. METHODS: We reviewed the sonograms and medical records of 7 patients with histologically proven lymphoma of the parotid (3 patients) or submandibular glands (4 patients). RESULTS: Primary lymphoma was found in 1 parotid gland and 2 submandibular glands. The remaining 4 cases were secondary lymphomas. One patient had been diagnosed with Sj?gren's syndrome and had been followed up with sonography. In parotid glands, both parenchymal and intraparotid nodal lymphomas were found. All submandibular gland tumors were parenchymal. Intraparotid nodal involvement appeared as multiple small nodules with relatively smooth margins, whereas the parenchymal parotid and submandibular gland lymphomas were larger (25 to 45 mm in longitudinal diameter) and showed various degrees of margin irregularity. All tumors were hypoechoic relative to the normal parenchyma. The primary parotid lymphoma and intraparotid nodal lymphomas had a homogeneous echotexture; the secondary parotid lymphomas and submandibular gland lymphomas were heterogeneous. One submandibular gland lymphoma showed intratumoral echogenic stripes. Neither calcification nor cystic degeneration was observed within the lesions. CONCLUSIONS: Lymphomas of the salivary glands present a variety of sonographic appearances, ranging from multiple small, hypoechoic nodules to an irregularly shaped heterogeneous mass without cystic areas or calcifications.     

Biopsy of the minor salivary glands in the differential diagnosis of Sj?gren's syndrome and chronic sialadenitis

The authors studied minor salivary gland morphology of 59 patients with different forms of chronic sialadenitis and Sjogren's syndrome (SS). The presence of pathomorphological changes in the salivary gland was established in chronic sialadenitis as well as in SS. However, these changes had distinctive features: total involvement in SS and mosaic patterns in chronic sialadenitis. The authors made a conclusion of the systemic involvement of the salivary glands in chronic sialadenitis.     

干燥综合征的腮腺和颌下腺损害特点分析

目的：通过比较干燥综合征组和正常对照组进行放射性核素显像的定量参数差异,观察干燥综合征患者的腮腺和颌下腺损害的各自特点。方法：38例干燥综合征患者均符合2002年干燥综合征国际分类（诊断）标准,对照组14例,所有病例按常规行唾液腺动态显像,并计算获得3项摄取功能参数：4min摄取比值（UR4）、15min摄取比值（UR15）、摄取速率（UV）;3项排泄功能参数：最大排泄量（MS）、酸刺激后腺体计数下降到最低所需的时间（Tmin）和1min内排泄速率（SV1min）,将两组定量参数进行t检验和Mann-Whitney U检验。结果：干燥综合征组腮腺不显影或显影不清楚的比例为2/38,干燥综合征组腮腺功能参数SV1min、UR15明显减低。颌下腺不显影或显影不清楚的例数为14/38,干燥综合征组颌下腺功能参数包括：UR4、UR15、UV、MS、SV1min均较对照组明显减低。结论：干燥综合征患者的腮腺与颌下腺功能损害并不是完全一致的。颌下腺损害更加常见,摄取和排泌量及速度均减低。腮腺仅高峰摄取比值和早期排泌速率明显减低,摄取速率和排泄量可表现正常。