Parotid gland: US findings in Sjögren syndrome. Work in progress.
TL;DR: It is suggested that bilateral cystic changes in the parotid glands may be the rule in uncomplicated cases of Sjögren syndrome.
Abstract: To determine the value of sonography of the parotid gland in patients with Sjogren syndrome, six consecutive cases were retrospectively reviewed in which clinical findings indicated Sjogren syndrome. All patients were women. Two patients were found at sonography to have normal parotid glands. Four patients had multiple cystic changes in the parotid glands bilaterally. Each of these four patients had a clinical diagnosis of Sjogren syndrome. One of the four underwent sialography, which demonstrated characteristic sialectasia. Pathologic examination of an excised gland in one of the patients with Sjogren syndrome demonstrated typical benign lymphoepithelial aggregates, which cause obstruction and progressive ductal dilatation. While parotid enlargement in these patients may be due to salivary tumor, lymphoma, or sarcoidosis--all of which appear as solid lesions at sonography--this study suggests that bilateral cystic changes may be the rule in uncomplicated cases of Sjogren syndrome.
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TL;DR: The role of imaging in assessment of salivary gland tumour is to define intra- glandular vs. extra-glandular location, detect malignant features, assess local extension and invasion, detect nodal metastases and systemic involvement, and determine tumour extent.
311 citations
TL;DR: In Sjögren's syndrome the sonographic changes correlate with the histological destruction, and in acute forms hypervascularization is found in color Doppler, which enables the diagnosis of cysts or ranulae.
Abstract: Due to their superficial position, the parotid, the submandibular, and the sublingual glands can be imaged with high-resolution transducers. In acute inflammatory diseases sonography can differentiate between obstructive or non-obstructive sialoadenitis. Abscess formations may be detected and the maturation of the colliquation may be controlled. Abscesses may be punctured under US guidance. In Sjogren's syndrome the sonographic changes correlate with the histological destruction, and in acute forms hypervascularization is found in color Doppler. In fibrotic cases the stimulation-induced hyperemia is impaired. In sialoadenosis inflammatory and tumorous lesions can be ruled out by sonography. Tumors of the salivary glands can be visualized with high sensitivity. Like other imaging methods the specificity in assessment of the histology of a tumor is low. Multilocular lesions, such as sarcoidosis, lymphoma, metastases, or cystadenolymphoma, are discussed. In deep located, malignant tumors or when the tumor cannot be delineated completely, MR or CT are obligatory to delineate the tumor. Sonography enables the diagnosis of cysts or ranulae. The accuracy of sonography in assessment of sialolithiasis is approximately 90%. Non-opaque stones can be visualized, too; however, small stones of less than 2 mm are difficult to detect since the posterior shadow may be missing. The concrements can be differentiated into intraductal or intraglandular stones. Indirect signs, such as ductal dilatations or inflammatory changes, may be found. Pseudotumorous lesions, such as hypertrophy of the masseter muscle, tuberculosis, sarcoidosis, or lymphoepithelial lesions in AIDS, are discussed. In children the main differential diagnosis of salivary gland pathologies are addressed. In many diseases sonography is the first-line imaging modality in assessment of salivary glands.
190 citations
Cites background from "Parotid gland: US findings in Sjögr..."
...The peripheral ductal system may be dilated; furthermore, multiple small cysts are found [15]....
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TL;DR: US, MR imaging and MR sialography with modern technology have reached such a good accuracy in visualizing glandular structural changes that they are promising alternatives to the conventional invasive examinations in the diagnostics of SS.
Abstract: Objectives. To evaluate ultrasonography (US) of salivary glands in primary Sjogren's syndrome (SS) and to compare US with parotid magnetic resonance (MR) imaging and MR sialography. Methods. US examination of parotid, submandibular and sublingual glands was performed on 27 patients with primary SS, 27 healthy controls and 27 symptomatic controls without SS. The results were compared with parotid MR imaging and MR sialography and the clinical features of the patients. Results. Salivary gland abnormalities, parenchymal inhomogeneity or adipose degeneration, were visualized in 21 (78%) SS patients, in one healthy control and in two symptomatic controls by US. Eighteen (67%) patients had changes in the parotid and submandibular glands and 8 (30%) changes in the sublingual glands. In the comparison, MR sialography was found to be the most sensitive method (96%), followed by MR imaging (81%) and US (78%), in detecting glandular changes. The specificity of US was 94%. The US and MR results were related to anti-Ro/SSA positivity but not to saliva secretion. The focus scores were related only to parotid MR imaging findings. Conclusions. US, MR imaging and MR sialography with modern technology have reached such a good accuracy in visualizing glandular structural changes that they are promising alternatives to the conventional invasive examinations in the diagnostics of SS.
158 citations
109 citations
TL;DR: In many clinical conditions, high‐resolution sonography and color (power) Doppler sonography can be used as the first‐line modality for evaluating cervical soft tissue masses and the relationship between a cervical mass and the great vessels can be evaluated.
Abstract: In many clinical conditions, high-resolution sonography and color (power) Doppler sonography can be used as the first-line modality for evaluating cervical soft tissue masses. Cervical cysts, lipomas, paragangliomas, neurogenic tumors, hemangiomas, and lymphangiomas often exhibit characteristic sonographic appearances. Sonography can be used for lymph node assessment, and most salivary gland diseases can be diagnosed sonographically. Sonography can be used to guide needle biopsy of soft tissue neoplasms and lymph nodes. In addition, the relationship between a cervical mass and the great vessels can be evaluated.
108 citations