慢性颌下腺炎的超声表现

目的探讨超声诊断慢性颌下腺炎的价值。方法结石型颌下腺炎组患者25例,非结石型颌下腺炎组患者11例,共39处病变;超声观察颌下腺的大小、形态、边界、腺体回声及血流分布特征,腺管有无扩张,腺管内有无结石,周围软组织、颌下区淋巴结和邻近唾液腺有无累及。结果结石型颌下腺炎组均为单侧发病;19例颌下腺形态饱满,18例颌下腺导管扩张伴结石,7例腺体内结石,3例腺体内及颌下腺导管内结石并存。非结石型颌下腺炎组,8例单侧病变,6例双侧病变;11例颌下腺形态饱满,腺体回声偏低、不均匀,呈"结节样"改变,"结节"大小3~15 mm。其中,6例颌下腺"结节"相互融合形成低回声"肿块"。腺体内血流丰富,但血管走行正常。病变颌下腺不伴导管扩张或结石。结论超声检查对于慢性颌下腺炎的诊断和治疗具有重要的参考意义,是一种有效的检查方法。     

Comparison of the sonographic features of acalculous and calculous submandibular sialadenitis.

OBJECTIVE: The purpose of this study was to compare the sonographic features of acalculous and calculous sialadenitis of the submandibular gland. METHODS: A retrospective review of sonograms of the neck was performed in 25 patients with submandibular sialadenitis: 8 with acalculous and 17 with calculous disease. The submandibular glands were assessed for size, shape, border, and echogenicity; presence of dilated ducts or other intraglandular lesions; inflammatory changes in adjacent tissues; lymphadenopathy; and involvement of other salivary glands. RESULTS: In the group with acalculous sialadenitis, 4 (50%) of the 8 patients had unilateral disease, and 11 (92%) of 12 glands were rounded. In all cases (100%), multiple hypoechoic lesions were diffusely distributed throughout the submandibular glands against a heterogeneous parenchymal background. The lesions ranged from 3 to 15 mm and were oval or round. Confluent lesions were noted in 2 glands (17%). There was no sonographic evidence of duct dilatation, calculi, or abnormal lymph nodes. All patients with calculous sialadenitis had unilateral disease; 9 had a main duct calculus (53%), 7 had intraglandular calculi (41%), and 1 had both (6%). In 14 (82%) of 17 glands, normal shape was maintained, and 11 (65%) of 17 had duct dilatation. CONCLUSIONS: Acalculous submandibular sialadenitis differs from the calculous form of the disease. The former has characteristic sonographic features, including a round gland with numerous hypoechoic lesions in a heterogeneous parenchymal background. Sonographic imaging in conjunction with fine-needle aspiration is useful for detection of this disorder.     

Liposarcoma of the diaphragm: CT and sonographic appearances

Malignant tumors arising from the diaphragm are exceedingly rare. We describe the first case, to our knowledge, of a primary diaphragmatic liposarcoma and demonstrate computed tomographic and sonographic findings.     

Thyrotoxic periodic paralysis: sonographic appearances of the thyroid

PURPOSE: The aim of the study was to describe the sonographic appearances of the thyroid in patients with thyrotoxic periodic paralysis (TPP). METHODS: Of the 25 patients diagnosed with TPP between January 1, 1998, and December 31, 2001, as identified by a search of our patient database, 13 had undergone sonography of the thyroid. We retrospectively reviewed the clinical records and thyroid sonograms of these 13 patients. The sonograms were assessed subjectively for thyroid size, echogenicity, vascularity, and the presence of solid nodules and cysts. RESULTS: Sonography showed abnormality of the thyroid in all 13 patients. In 11 patients (85%), sonography showed widespread hypoechogenicity (compared with the muscle) whose distribution was diffuse (6 patients) or patchy (5 patients) and diffusely distributed areas of hypervascularity (type 1 pattern). All 11 of these patients had a clinical diagnosis of Graves' disease. One patient (8%) had multinodular goiter and enlargement of the thyroid with multiple heterogeneous solid nodules and cysts (type 2 pattern); the clinical diagnosis was toxic multinodal goiter. One patient (8%) had a combination of type 1 and type 2 patterns and a clinical diagnosis of Graves' disease. CONCLUSIONS: The sonographic abnormalities of the thyroid in patients with TPP reflect the common underlying causes of thyrotoxicosis in the general population. The sonographic appearances associated with Graves' disease (type 1 pattern) were the most common abnormality detected. No sonographic features specific to TPP were identified.     

Hydrocele of the canal of Nuck: sonographic and MRI appearances

Hydrocele of the canal of Nuck is a rare disorder in females. A 50-year-old female presented with the complaint of swelling and occasional pain in the right groin. Sonographic examination revealed a proximal dilatation at the inguinal canal with a 3-cm ovoid, septated cystic lesion at the distal end. The mass appeared as a simple cyst on MRI. Valsalva's maneuver during real-time sonography helped differentiate the hydrocele of the canal of Nuck from an inguinal hernia.     

Sonographic appearances of mucosa-associated lymphoid tissue lymphoma of the submandibular gland confirmed with sonographically guided core needle biopsy

A 71-year-old man presented with mucosa-associated lymphoid tissue (MALT) lymphoma of the submandibular gland 52 months after initial diagnosis of MALT lymphoma of the lung. Ultrasonography showed a well-demarcated, markedly hypoechoic, heterogeneous solid mass with linear echogenic strands and hypervascularity. Ultrasound-guided core-needle biopsy demonstrated histological findings of MALT lymphoma. Sonographic features of MALT lymphoma of the submandibular gland are characteristic and ultrasound-guided core-needle biopsy may be a suitable replacement for surgical biopsy.     

Various sonographic appearances of the hemorrhagic corpus luteum cyst

Although hemorrhagic corpus luteum cysts are frequently seen during sonography of the female pelvis, their diagnosis is often challenging as a result of variations in size, thickness of the cyst wall, and internal echo pattern depending on the formation and lysis of the clot. There are cases in which hemoperitoneum is the most obvious finding. The differential diagnosis is extensive and includes ectopic pregnancy, adnexal torsion, neoplasm, and pelvic inflammatory disease. This review describes and illustrates the diverse appearances of the hemorrhagic corpus luteum, as well as other etiologies of adnexal pathology that can mimic the appearance of a hemorrhagic corpus luteum sonographically.     

睾丸损伤的超声分型及临床应用评价

目的　探讨睾丸损伤的超声分型及其临床应用价值。方法　分析 15例阴囊闭合性损伤的高频彩色多普勒超声表现和手术所见。结果　 15例阴囊外伤中 ,睾丸完全破裂 2例 ,部分破裂 4例 ,挫伤 4例 ,单纯血肿 3例 ,正常 2例。睾丸损伤的超声诊断符合率为 93 .3 % (14 /15 )。睾丸损伤的超声表现可分为破碎型、破裂型、钝挫型和包膜下血肿型。结论　超声检查不但能够对睾丸损伤进行分型 ,而且有助于临床治疗方案的选择。     

Thyroid carcinoma metastasizing to the submandibular gland: Sonographic findings

Metastases to the submandibular gland are extremely rare; a literature search retuned only three previously reported cases from a thyroid gland primary site. Herein, we report two cases of metastatic thyroid carcinoma to the submandibular gland in a 64-year-old woman with PTC and a 70-year-old-woman with medullary thyroid carcinoma (MTC). The metastases were identified on CT and PET/CT in one case and on CT in the other case, but both were diagnosed with ultrasound-guided fine-needle aspiration. Our cases highlight that while rare, both PTC and MTC can metastasize to the submandibular gland.     

High-resolution real-time ultrasonography of the submandibular salivary gland

Twenty "normal" volunteers underwent real-time ultrasound scanning of their submandibular salivary glands in an attempt to define the normal anatomy and ultrasound characteristics of these glands and their adjacent anatomy. It is possible to define the entire gland and portions of its duct, which measures less than 3 mm in diameter. Adjacent structures are easily seen and are constant in their relationships to the gland. Three case reports demonstrate the usefulness of this approach to various clinical problems. Real-time ultrasonography is an easily applied, non-ionizing modality to image the submandibular fossa.     

Sclerosing polycystic adenosis of the submandibular gland: Two case reports

BACKGROUNDSclerosing polycystic adenosis (SPA) is a rare disease of salivary glands, similar to fibrocystic disease of the breast. It occurs over a wide age range and exhibits a slight female preference. Most SPA cases have occurred in the parotid gland. The exact nature of SPA is unclear, but its tumor nature has recently been proposed. Although SPA has a good prognosis after adequate surgery, atypical lesions might occur, ranging from mild dysplasia to carcinoma in situ in some cases. To the best of our knowledge, only five cases of SPA in the submandibular gland have been reported to date. Here, we present two new cases of SPA involving the submandibular gland.CASE SUMMARYA 50-year-old woman and a 52-year-old woman were referred to Tongji Hospital in Wuhan, China, with complaints of moderate pain, recurrent swelling, and a mass in the submandibular area. After admission, the two cases of the submandibular mass were examined physically. The boundary of the submandibular tumor was clear, and the range of motion was good. After preoperative examinations, surgery was performed on a selective basis. Postoperative histopathological examination revealed a well-defined mass with acinar structures, ducts, or cystic dilated glands of various sizes scattered in a large number of proliferative sclerosing stroma. There were flat and cuboidal cells, and eosinophils in the duct epithelium. There was also a eosinophilic substance in the lumen of dilated cysts. No atypical epithelial hyperplasia, invasive growth, or carcinoma in situ was found. Based on the above findings, the mass was diagnosed as SPA. Both patients have remained asymptomatic and no recurrence or distant metastasis had occurred by the 7-mo and 5-year follow-up, respectively.CONCLUSIONSPA is a rare disease of the salivary gland. Even though it has a good prognosis after adequate surgery, atypical lesions may occur from mild dysplasia to carcinoma in situ. However, no recurrence, distant metastasis, or mortality has been reported for submandibular gland SPA. Clinicians and pathologists should be familiar with the characteristics of SPA in the submandibular gland to avoid misdiagnosis and overtreatment.     

Agenesis of a submandibular gland with compensatory pseudotumoral hypertrophy of the contralateral gland: Sonographic findings

Agenesis of a submandibular gland with compensatory hypertrophy of the contralateral gland is an extremely rare disorder. Most reported cases of unilateral submandibular agenesis have been asymptomatic without any associated facial anomalies. We report a case of submandibular gland hypertrophy mimicking a mass that was detected incidentally. The absence of the contralateral submandibular gland and associated contralateral sublingual gland hypertrophy was confirmed by typical imaging findings. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound 41 :15–17, 2013     

Gray-scale and power doppler sonographic appearances of acute inflammatory diseases of the scrotum

PURPOSE: We describe the spectrum of gray-scale and power Doppler sonographic appearances in inflammatory scrotal diseases. METHODS: Twenty-five patients ranging in age from 3 to 69 years underwent gray-scale and power Doppler sonography with multifrequency transducers of 7-9 MHz or 10-13 MHz. In addition, color Doppler and power Doppler findings were compared in 7 cases. RESULTS: In all 5 prepubertal patients, power Doppler imaging demonstrated hyperemia associated with epididymitis and, in some cases, orchitis. Among the 20 pubertal and adult patients, power Doppler imaging revealed increased vascularity associated with spermatic cord involvement, epididymitis, orchiepididymitis, or orchitis. Enlargement and heterogeneity of the epididymis and/or testis were seen in 11 patients, with vas efferens ectasia in 3 patients. Abscess formation and testicular infarction were easily depicted by power Doppler imaging. In 5 cases total, hyperemia was the only sonographic finding of inflammation. In the comparison between color and power Doppler imaging, a subjective increase in the number and length of vessels was seen with power Doppler imaging. CONCLUSIONS: Power Doppler imaging is an easy and fast Doppler modality for evaluating inflammatory conditions of the scrotum and proved especially useful in cases with no gray-scale sonographic anomalies, in prepubertal patients, and in patients with abscesses or ischemic lesions.