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Clinical application of magnetic resonance sialographic 3-dimensional reconstruction imaging and magnetic resonance virtual endoscopy for salivary gland duct analysis.

PURPOSE: In a previous study, we showed that the new and fast sequence 3-dimensional (3D)-fast asymmetric spin-echo sequencing could be applied in magnetic resonance (MR) sialographic 3D reconstruction imaging of the parotid gland ducts and in producing virtual endoscopic views of the parotid gland with MR data. MATERIALS AND METHODS: In the present study, we examined the clinical application of these MR sialographic 3D reconstruction imaging and virtual endoscopy of the salivary gland ducts using MR data sets with 3D-fast asymmetric spin-echo sequencing. RESULTS: The MR sialographic 3D reconstruction images showed a complete view in the branch paths from all angles, and the MR virtual endoscopic views showed conditions in the endoluminal tracts of the large branches in 20 patients with salivary gland duct abnormalities, including Sjögren syndrome, cyst, tumor, sialadenitis, and salivary calculi. CONCLUSION: The clinical use of MR sialographic 3D reconstruction imaging and MR virtual endoscopy for salivary gland ducts may enhance understanding of the 3D relationship between the ducts and the surrounding tissue, as well as the endoluminal circumstance within ducts. Possible future applications abound, and further investigation in this field is expected.

Adolescent↗

Multiple sialolithiasis in the parotid gland with Sjögren's syndrome and its sonographic findings--report of 3 cases.

We present 3 cases of Sjögren's syndrome in which multiple sialolithiasis were observed in the parenchyma of the parotid gland. The sonographic examinations showed microliths that were observed as hyperechoic spots. Some of the microliths were accompanied with comet sign, however most of them showed no particular posterior echoes. None of them showed acoustic shadows, which are normally observed in cases with sialolithiasis. We were able to prove that some of the hyperechoic spots observed sonographically in patients with severe Sjögren's syndrome were microliths. Although these multiple microliths are rarely detected, they may exist potentially in higher frequency in patients with severe Sjögren's syndrome.

Contrast Media↗

Symmetry of the submandibular glands in humans--a postmortem study assessing the linear morphometric parameters.

BACKGROUND: The analysis of morphometric right-left symmetry of the salivary glands is important for assessing unilateral changes discovered in these organs during diagnostic imaging. STUDY DESIGN: A study was carried out on 18 adult human autopsy neck and maxillofacial specimens from both sexes (14 males, 4 females), with age range of 17 to 73 years (mean age 49.9 years). The submandibular duct was injected with contrast medium and images were made in two projection planes. RESULTS: Morphometry performed using the obtained radiographs included: (a) caliber (mean proximal, middle, and distal = 1.73 mm, 1.82 mm, and 1.77 mm), (b) length (mean = 37.2 mm); (c) genu of the submandibular duct (mean = 114 degrees ); and (d) longitudinal and transverse diameters of the gland (mean = 44.1 mm and 25.9 mm). Comparison of these morphometric parameters between the right and the left glands revealed no statistically significant differences. CONCLUSION: There is a high level of right-left symmetry in linear morphometric parameters of the submandibular gland.

Adolescent↗

Salivary duct carcinoma.

Salivary duct carcinoma (SDC) is a highly malignant tumor that is histologically similar to ductal carcinoma of the breast. This article presents the clinicopathologic features of 15 patients with SDC arising in the salivary glands. The majority of patients were male and aged 65 years or older. The tumor was most often located in the parotid gland. Pain, facial palsy, and presence of calcification in the CT scan were diagnostic features suggestive of SDC. Histologically, 27% of the tumors arose from pre-existing pleomorphic adenoma. Perineural and lymphatic invasion were common findings. There was an extensive cervical lymph node involvement (73%). Distant metastasis was the most common cause of failure. Although SDC exhibits an unpredictable clinical course, total parotidectomy with neck dissection and adjunctive radiation therapy appear to be appropriate for local and regional control of this aggressive neoplasm.

Adult↗