Effects of Chinese herbs on salivary fluid secretion by isolated and perfused rat submandibular glands

AIM:To determine whether Chinese herbs (CHs) relieve xerostomia (dry mouth) by increasing salivary secretion.METHODS: The submandibular glands of Wistar rats were surgically isolated and perfused arterially with buffered salt solution. After control perfusion, recording started 5 min prior to the start of stimulation. After fluid secretion was induced by 0.2 μmol/L carbamylcholine (CCh) in the perfusate for 10 min, Chinese herb (CH) was added in the perfusion for 5 min. CCh was then overloaded at 0.2 μmol/L in the perfusion for 20 min. The volume of salivary fluid secretion was recorded by a computer-controlled balance system.RESULTS: Saliva secretion formed an initial ephemeral peak at 30 s followed by a gradual increase to a sustained level. CH alone induced no or little saliva in all types of CH selected. During perfusion with CH,overloading of CCh promoted fluid secretion in 15 of 20 CHs. This promotion was classified into four patterns, which were eventually related to the categories of CH: Overall sustained phase was continuously raised (Yin-nourishing, fluid production-promoting and heat-clearing agents); The sustained secretion rose to reach a maximum then decreased (Qi-enhancing agent); Sustained secretion rose to reach the highest maximum and was then sustained with a slight decline (swelling-reducing, phlegm-resolving and pus-expelling agents); Stimulation of salivary secretion without any added stimulants. Addition of CCh raised the fluid secretion to reach the highest maximum then sharply decreased to a lower sustained level (blood activating agent).CONCLUSION: The present findings lead to the conclusion that various CHs have different promotional effects directly on the salivary gland.

Two Cases of Epidermoid Cyst of the Buccal Floor Simulating: A Tumour of the Submandibular Gland

Dermoid cyst of the oral floor is rare benign tumour, who having three histological aspects: dermoid, teratoid and epidermoid. This one is characterized by the presence of a squamous stratified epithelium with cutaneous remnants. It may occur in any part of the body, however their frequency in the ENT sphere is relatively scarce. Seven per cent (7%) only of epidermoid cysts occur in the cervico-facial area, 1.6% of which locate at the floor level. When they are located submandibular, they can pose diagnostic difficulties and look like a tumour of the submaxillary gland. We report two cases of epidermoid cyst of the floor. Both patients suffered from swelling of the submandibular gland. Magnetic Resonance Imaging was not requested due to lack of resources. However, surgery allowed in both cases the excision of a cyst next to a normal submandibular gland. Patients did well post operatively.

Effects of Low Concentration Samarium Chloride on theUltrastructure and Function of Rat Thyroid Gland

The levels of thyroxine (T3, T4) and thyroid stimulating hormone (TSH) in rat serum were measured by radioimmunoassay, and also ultrastructure of the thyroid gland and adenohypophyseal cell were examined by transmission electronic microscopy (TEM) after low concentration (0. 05 mg/kg) of samarium chloride (SmCl3) administration by intraperitoneal, oral and tail intravenous routes. The results showed that the level of T4 in rat serum increased and the level of TSH unchanged by the intraperitoneal administration, and the levels of T3, T4 and TSH did not increase by the oral and tail intravenous administration. The evidences mentioned above were in accord with the morphological changes of thyroid follicular epithelial cells andadenohypophysis thyrotroph observed under electronic microscope in a sense.

Botulinum toxin A inhibits salivary secretion of rabbit submandibular gland

Botulinum toxin A （BTXA） has been used in several clinical trials to treat excessive glandular secretion; however, the precise mechanism of its action on the secretory function of salivary gland has not been fully elucidated. In this study, we aimed to investigate the effect of BTXA on secretion of submandibular gland in rabbits and to identify its mechanism of action on the secretory function of salivary gland. At 12 weeks after injection with 5 units of BTXA, we found a significant decrease in the saliva flow from submandibular glands, while the salivary amylase concentration increased. Morphological analysis revealed reduction in the size of acinar cells with intracellular accumulation of secretory granules that coalesced to form a large ovoid structure. Expression of M3-muscarinic acetylcholine receptor （M3 receptor） and aquaporin-5 （AQP5） mRNA decreased after BTXA treatment, and distribution of AQP5 in the apical membrane was reduced at 1, 2 and 4 weeks after BTXA injection. Furthermore, BTXA injection was found to induce apoptosis of acini. These results indicate that BTXA decreases the fluid secretion of submandibular glands and increases the concentration of amylase in saliva. Decreased expression of M3 receptor and AQP5, inhibition of AQP5 translocation, and cell apoptosis might involve in BTXA-reduced fluid secretion of submandibular lands.

Bone marrow-derived mesenchymal stem cells migrate to healthy and damaged salivary glands following stem cell infusion

Xerostomia is a severe side effect of radiation therapy in head and neck cancer patients. To date, no satisfactory treatment option has been established. Because mesenchymal stem cells（MSCs） have been identified as a potential treatment modality, we aimed to evaluate stem cell distribution following intravenous and intraglandular injections using a surgical model of salivary gland damage and to analyse the effects of MSC injections on the recruitment of immune cells. The submandibular gland ducts of rats were surgically ligated. Syngeneic adult MSCs were isolated, immortalised by simian virus 40（SV40） large T antigen and characterized by flow cytometry. MSCs were injected intravenously and intraglandularly. After 1, 3 and 7 days, the organs of interest were analysed for stem cell recruitment. Inflammation was analysed by immunohistochemical staining. We were able to demonstrate that, after intravenous injection, MSCs were recruited to normal and damaged submandibular glands on days 1, 3 and 7. Unexpectedly, stem cells were recruited to ligated and non-ligated glands in a comparable manner. After intraglandular injection of MSCs into ligated glands, the presence of MSCs, leucocytes and macrophages was enhanced, compared to intravenous injection of stem cells. Our data suggest that injected MSCs were retained within the inflamed glands, could become activated and subsequently recruited leucocytes to the sites of tissue damage.

Thermal influence of saliva secretion <i>ex vivo</i>in the mouse submandibular gland

The physiological and pharmacological responses of an ex vivo mouse submandibular gland were used to study fluid secretion and cell signaling in response to muscarinic stimulation at increasing temperatures. Saliva production at 37°C was 5.5-fold that at 25°C with pilocarpine stimulation and 9.8-fold that at 25°C with cevimeline stimulation. Both of these muscarinic agonists are used clinically. With the experimental agonist carbachol (CCh), saliva secretion was increased with an increase in temperature, but the CCh concentration producing the peak flow was the same in both dose-response curves, suggesting that the muscarinic receptor itself is not responsible for the temperature dependence. Purinergic agonists also induced temperature-dependent saliva production ex vivo. The calcium ionophore A23187 failed to have a significant effect on saliva production. The CCh-induced increase in intracellular Ca2+ also upregulated the initial increase and sustained the plateau phase of saliva flow. Thus, muscarinic receptor stimulation of saliva production is temperature sensitive due to an increase in intracellular Ca2+.

Sclerosing polycystic adenosis of the submandibular gland: Two case reports

BACKGROUND Sclerosing 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 SUMMARY A 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 prognosisafter adequate surgery, atypical lesions may occur from mild dysplasia tocarcinoma in situ. However, no recurrence, distant metastasis, or mortality hasbeen reported for submandibular gland SPA. Clinicians and pathologists shouldbe familiar with the characteristics of SPA in the submandibular gland to avoidmisdiagnosis and overtreatment.

Salivary duct carcinoma of the submandibular gland presenting a diagnostic challenge: A case report

BACKGROUND Salivary duct carcinoma(SDC)is a rare,extremely aggressive malignancy that arises in the submandibular gland.It can metastasize locally early and therefore is an important differential diagnosis of metastatic disease in cervical lymph nodes or specific lymphadenitis such as tuberculous cervical lymphadenitis.CASE SUMMARY We report a case of SDC in the submandibular gland that presented diagnostic difficulty.The lesion was coincidentally discovered through examination of the radiolucent area of the maxilla.Imaging failed to confirm the possibility of specific inflammation,leading us to execute an open biopsy to verify the diagnosis.The surgical specimen showed that the submandibular gland was primarily replaced with a calcified body.Following histological analysis and confirmation,we performed surgical resection,radiotherapy,and various chemotherapies.CONCLUSION Radiographic imaging characteristics of lymph node metastases of salivary gland cancer,especially of SDC,may resemble other cervical lymphadenitis;calcification at the submandibular gland is the landmark of SDC occurring at the submandibular gland.

Possible Role of the Submandibular Gland in the Development of Obesity in Mice

The possible role of submandiblular glands (SMG) in the development of obesity was studied in two types of genetically obese mice, ob/ob and yellow Ay: Obesity is caused by hyperplasia followed by hypertrophy in ob/ob mice and mainly by hypertrophy in Ay mice.The histological features of SMGs exhibited clear sexual dimorphism in both mice similarto lean controls. The SMGs of ob/ob mice was smaller in size and had smaller granular convoluted tubular portions than lean controls, while the SMGs of Ay mice did not differ from lean controls. Sialoadenectomy before and after development of obesity gCnerally reduced the gain of body weights in both sexes of Ay mice but not in ob/ob mice. The content of epidermal growth factor (EGF) in the SMGs was higher in Ay mice and lower in ob/ob mice than their controls. The possible role of EGF in the SMGs in the development of obesity is discussed

Clinical significance of hypoechoic submandibular gland lesions in type 1 autoimmune pancreatitis

AIM To assess the role of ultrasonography of submandibular glands(SGs) in the diagnosis of type 1 autoimmune pancreatitis(AIP). METHODS Thirty-seven patients who were definitively diagnosed with type 1 AIP according to the international consensus diagnostic criteria(ICDC) for AIP at our institution between December 1990 and April 2016 were retrospectively reviewed. Findings by physical examination, ultrasonography, and scintigraphy of SGs were analyzed to reach a diagnosis based on the ICDC for AIP. The efficacy of corticosteroid treatment in the resolution of hypoechoic lesions in SGs was also evaluated by assessment with ultrasonography before and after treatment in 18 cases.RESULTS The sensitivity of multiple hypoechoic lesions in SGs by ultrasonography for the diagnosis of sialadenitis in type 1 AIP(84%) was higher than that of physical examination(46%), scintigraphy(28%), and SGs thickness(49%). Ultrasonographic evidence of hypoechoic lesions in SGs improved the definitive diagnosis of sialadenitis and type 1 AIP by the ICDCcriteria in 11(30%) and 2(5.4%) cases, respectively. Multiple hypoechoic lesions in SGs were resolved or disappear by corticosteroid administration in 14 of 16 cases with hypoechoic lesions in SGs, whereas the ultrasonographic findings in the remaining 2 cases with hypoechoic lesions in SGs and the 2 cases with homogenous SG parenchyma remained unchanged after corticosteroid administration.CONCLUSION SG ultrasonography to detect multiple hypoechoic lesions might be useful for type 1 AIP diagnosis by improving diagnostic accuracy together with the ICDC sialadenitis criteria.

Changes of norepinephrine and tumor necrosis factor in submandibular gland of rats with sympathetic nerve injury and the protective effect of 17 beta-estradiol

BACKGROUND： Recent researches have indicated that estrogen has extensive neuroprotective effects. So some studies designed ovariectomized animal models and administrated with estrogen, so as to verify its neuroprotective effects. OBJECTIVE： To observe the effect of 17 beta-estradiol on the content of norepinephrine （NE） and level of tumor necrosis factor （TNF） in submandibular glands of rats with sympathetic nerve injury, and analyze the dose-dependence and pathway of action. DESIGN： A randomized control animal study SETTINGS： Department of Hand Surgery, the 252 Hospital of Chinese PLA; Department of Hand Surgery Union Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology. MATERIALS： Fifty healthy female Wistar rats were randomly divided into 5 groups with 10 rats in each group： sham-operated group, ovariectomy＋6-OHDA＋saline group, ovariectomy＋6-OHDA＋17β-estradiol 50, 200 and 500 μg/kg groups. METHODS： The experiments were carried out in Tongji Medical College, Huazhong University of Science and Technology between October 2005 and March 2006. Bilateral ovaries were only exposed but not resected for the rats in the sham-operated group, but bilateral ovaries were resected in all the other groups. In the ovariectomy＋6-OHDA＋176-estradiol 50, 200 and 500 μg/kg groups, the rats were administrated with intraperitoneal injection of 6-OHDA （8 mg/kg）, and then immediately given 176-estradiol of corresponding dosages respectively, once a day for 10 days continuously. Rats in the sham-operated group and ovariectomy＋6-OHDA＋saline group were administrated with saline of the same volume. After administration, 5 rats in each group were killed to determine the NE contents in bilateral submandibular glands with high performance liquid chromatography-electrochemical detector （HPLC-ECD）, and the other 5 rats were used to determine the TNF levels in submandibular glands with enzyme-linked immunosorbant assay. MAIN OUTCOME MEASURES： The NE contents and TNF levels in submandibular glands of rats in each group were observed. RESULTS： All the 50 rats were involved in the analysis of results. （1） The NE content was obviously lower in the ovariectomy＋6-OHDA＋saline group than in the sham-operated group [（1 035±196）, （1 823±314） ng/g, P 〈 0.05], there were no significant differences between the ovariectomy＋6-OHDA＋17β-estradiol 50 μg/kg group and ovariectomy＋6-OHDA＋saline group [（1 004±253）, （1 035±196） ng/g, P 〉 0.05], but obviously higher in the ovariectomy＋6-OHDA＋17β-estradiol 200 and 500 μg/kg groups than in the ovariectomy＋6-OHDA＋saline group [（1 487±268）, （1 939±274）, （1 035±196） ng/g, P 〈 0.05]. （2） The TNF level was obviously higher in the ovariectomy＋6-OHDA＋saline group than in the sham-operated group [（3.498±0.792）, （1.893±0.533） ng/g, P 〈 0.05], there were no significant differences between the ovariectomy＋ 6-OHDA＋17β-estradiol 50 μg/kg group and ovariectomy＋6-OHDA＋saline group [（3.328 ±0.712）, （3.498±0,792） ng/g, P 〉 0.05], but obviously lower in the ovariectomy＋6-OHDA＋17β-estradiol 200 and 500 μg/kg groups than in the ovariectomy＋6-OHDA＋saline group [（2.639±0.438）, （2.016±0.619）, （3.498＋0.792） ng/g, P 〈 0.05]. CONCLUSION： Estrogen has obvious protective effect dose-dependently on 6-OHDA induced chemical sympathetic nerve terminal injury in rats, and it may play its protective role by reducing TNF level and ameliorating inflammatory reaction.

莱氏拟乌贼输卵管腺超显微结构

为了解莱氏拟乌贼(Sepioteuthis lessoniana)输卵管腺的结构和功能,通过解剖学、组织切片和透射电镜技术对腺体进行解剖学及超显微结构观察。解剖结果显示,莱氏拟乌贼具有1个输卵管腺,由圆饼状近端输卵管腺和圆柱状远端输卵管腺构成,整体呈白色,靠近内壳侧具有棕黄色的色素沉着,透明瓣膜位于腺体末端。显微结果显示,输卵管腺由腺壁组织包裹,由外向内分别是外膜层和结缔组织。外膜层由柱状上皮细胞构成,结缔组织中分布少量肌肉组织和血管;腺体的外膜层和透明瓣膜的外表层中分布少量杯状细胞,瓣膜主要由肌肉组织构成。腺体内部是分泌叶瓣,在腺体中呈层状分布,叶瓣依附于腺壁组织。电镜结果显示,分泌细胞个体较大,细胞核呈圆形或椭圆形,包含大量内质网、线粒体和高尔基体等细胞器,此外,胞内分布大量黏液颗粒,细胞外连续着生纤毛。透明瓣膜主要由肌细胞构成,可见横切和纵切的肌丝以及大量的胶原纤维。研究表明,输卵管腺具备分泌功能,其分泌物形成受精卵的内层卵鞘,在受精卵孵化过程中具有重要作用。本研究首次对莱氏拟乌贼的输卵管腺进行超显微结构观察,描述了输卵管腺的外部形态构造和内部结构特征,分析并总结了该腺体的结构和功能,为头足类生殖腺体的相关研究提供一定参考。

细针吸取活检在下颌下腺肿物诊断中的价值及误诊原因分析

目的探讨细针吸取活检(FNA)对下颌下腺肿物的诊断价值。方法回顾2013-2022年就诊于首都医科大学附属北京友谊医院口腔科,行FNA并获得最终病理的下颌下腺肿物患者,以最终病理为金标准,计算FNA诊断各型下颌下腺肿物的准确性、灵敏度、特异性、安全性,分析误诊原因。结果共纳入114例患者。非肿瘤性疾病多为IgG4-RD,FNA诊断准确度为91.2%,灵敏度97.4%,特异性88.2%。FNA诊断下颌下腺良性肿瘤准确度:86.8%,灵敏度:81.7%,特异度:92.6%。FNA诊断下颌下腺恶性肿瘤准确度为93.0%,灵敏度62.5%,特异性98.0%。误诊原因包括10例取样误差及8例病理类型误判。结论FNA在诊断IgG4相关性下颌下腺炎中极具价值,在诊断下颌下腺恶性肿瘤灵敏度较低,有误诊可能,需结合患者资料进行综合考虑。

双侧颌下腺硬化性多囊性腺瘤1例

患者男,41岁,发现颌下2个无痛肿物缓慢增大10年,外院超声提示混合瘤可能性大;既往体健。查体:颌下左、右侧分别扪及2.5 cm×1.4 cm、3.0 cm×1.7 cm质硬肿物,边界清,活动度可,无压痛,表面皮肤无红肿、破溃,挤压双侧颌下腺后见清亮唾液自导管口溢出;未触及头颈部浅表淋巴结肿大。实验室检查未见明显异常。颈部CT:双侧颌下腺增大,左、右侧分别见直径2.6、2.7 cm密度不均匀结节,边界清,伴多发钙化(图1A),增强后轻度欠均匀强化(图1B)。CT诊断:双侧颌下腺良性病变可能性大。行双侧颌下腺肿物并腺体切除术。术后病理:光镜下见大量增生胶原纤维,其间导管及腺泡成分不规则分布、增生,呈模糊小叶状结构,部分导管扩张呈囊状;免疫组织化学:E-cadherin(-),CD71(-),CD61(-),MPO(-),CD45(+)。病理诊断:(双侧颌下腺)硬化性多囊性腺瘤(sclerosing polycystic adenoma,SPA)。本例报道经医院伦理委员会批准(梅市伦审2024-C-12)。

疑难唾液腺结石病的治疗研究

唾液腺结石病在人群中的发病率为0.45%~1.20%,主要表现为受累腺体反复肿胀、疼痛,进食时加重,扪压腺体可见脓性分泌物溢出^([1-3])。随着唾液腺内镜及碎石技术的应用与发展,多数唾液腺结石病的治疗已不再是难题,但对于位置深在的下颌下腺腺门部与腺内段结石及位置靠后的腮腺嵌顿性结石等复杂病例的治疗仍存在挑战,需要进一步突破^([4-6])。北京大学口腔医院唾液腺疾病研究中心开展唾液腺内镜诊疗工作17年来.

内镜下唾液腺切除术式的变迁与趋势——从内镜辅助到完全内镜

内镜外科在我国经历了30余年的快速发展,已经成为很多外科专业的主流术式。从首次报道至今,内镜在唾液腺切除术中的应用已有20余年。纵观内镜外科的总体发展历程,现阶段口腔颌面外科的内镜手术仍处于早期探索阶段,尚未得到成熟推广应用。得益于其他学科的引领和经验,口腔颌面外科的内镜技术有希望能够实现跨越式的发展。本文从内镜发展的总脉络出发,对内镜在唾液腺切除手术中的应用历史、现状与未来发展的趋势作一论述。

活血解毒润燥方干预干燥综合征小鼠颌下腺细胞凋亡促进因子Smac表达的机制研究

目的:将干燥综合征(SS)模型小鼠颌下腺细胞凋亡促进因子Smac的表达作为靶点,探究活血解毒润燥方对SS模型小鼠颌下腺组织形态、腺体功能、细胞凋亡的影响及其干预机制。方法:实验选取雌性BALB/c57小鼠为正常对照组,自发性雌性非肥胖型糖尿病(NOD/Ltj)小鼠为SS模型并随机分为模型组、白芍总苷胶囊组和活血解毒润燥方低、中、高剂量组,每组各15只。各组小鼠给药量按照人与动物体表面积比计算等效剂量,正常对照组、模型组小鼠灌胃10 ml/kg蒸馏水,白芍总苷胶囊组(0.234 g/kg)和活血解毒润燥方低剂量组(15.6 g/kg)、中剂量组(31.2 g/kg)、高剂量组(62.4 g/kg)分别灌胃给药,每日1次。药物干预8周后,无菌分离颌下腺,观察各组小鼠颌下腺形态、功能的改变,并分别应用免疫组化法(IHC)、蛋白免疫印迹法(Western blot)、逆转录聚合酶链式反应(RT-PCR)测定细胞凋亡促进因子Smac的表达。结果:与正常对照组比较,模型组唾液流量及颌下腺指数均显著降低(P<0.01),颌下腺组织病理学评分显著升高(P<0.01),IHC和Western blot检测Smac表达明显升高(P<0.05),RT-PCR检测Smac表达显著升高(P<0.01)。治疗结束后,与模型组比较,活血解毒润燥方各剂量组和白芍总苷胶囊组唾液流量及颌下腺指数均显著升高(P<0.01),颌下腺组织病理学评分显著降低(P<0.01)。运用IHC和Western blot检测活血解毒润燥方高剂量组和白芍总苷胶囊组Smac表达明显降低(P<0.05),运用RT-PCR检测活血解毒润燥方高剂量组与白芍总苷胶囊组Smac表达显著降低(P<0.01)。结论:活血解毒润燥方可以改善SS模型鼠颌下腺腺泡的分泌功能,提高其颌下腺指数,增加SS模型鼠的唾液分泌量;其作用机制与下调SS模型鼠颌下腺细胞凋亡、促进因子Smac的表达水平有关。

麦蛾柔茧蜂幼虫唾液腺的显微与超微形态观察

本文采用解剖学观察、显微摄影、透射电镜等方法对麦蛾柔茧蜂Habrobracon hebetor幼虫唾液腺的显微形态、超微结构以及发育特性进行了观察和分析。麦蛾柔茧蜂幼虫唾液腺为一对无色透明至乳白色的管状腺体,自口腔沿中肠两侧向后延伸,单侧腺体在中部先分支、后合并成一不规则环状,端部呈单盲管状。唾液腺管道长度随幼虫龄期增加而呈线性增长。对唾液腺切片进行超微结构观察,发现腺管由两类差异明显的单层细胞组成,Ⅰ型细胞微绒毛层较厚,胞内除有丰富的内质网和线粒体之外,还含有大量囊泡,并观察到囊泡运输分泌颗粒的现象;Ⅱ型细胞微绒毛短,胞内的内质网和线粒体数量丰富。本文研究为深入探究寄生蜂幼虫的消化生理以及寄生蜂-寄主互作机制奠定了基础。

左下颌下腺导管内乳头状瘤1例

患者男,54岁,无意中触及左颌下核桃大小肿物1年,近6个月明显增大,直径约5 cm,无明显不适;既往高血压5年。查体:左、右侧颜面部不对称,张口度三指,左颌下区明显肿胀并扪及直径约5 cm肿物,无触痛及压痛,质软,活动度可。实验室检查未见明显异常。超声:左颌下5.21 cm×3.11 cm×4.67 cm囊实性肿块,边界清,回声不均,实性部分约2.10 cm×1.22 cm×1.67 cm,CDFI于其内探及点状血流信号,弹性评分3分;超声造影动脉期呈不均匀高增强、静脉期消退缓慢,囊性部分未见明显增强(图1A);提示左下颌下腺良性肿瘤。

超声弹性成像对干燥综合征不同腺体病变的诊断价值

目的探讨超声弹性成像对干燥综合征(SS)不同腺体病变的诊断价值。方法选取我院就诊的75例疑似SS患者,根据欧美专家共识诊断标准(2002年版)将其分为SS患者35例(研究组)和非SS患者40例(对照组),应用超声弹性成像测量两组腮腺和颌下腺剪切波速度(SWV)值,取其平均值为唾液腺SWV值,分析两组间及各组左右侧SWV值的差异。绘制受试者工作特征(ROC)曲线分析超声弹性成像对SS不同腺体病变的诊断效能。结果研究组腮腺、颌下腺、唾液腺SWV值均高于对照组,差异均有统计学意义(均P<0.05)。对照组和研究组内左右侧腮腺、颌下腺、唾液腺SWV值比较差异均无统计学意义。ROC曲线分析显示,当SWV值为1.94 m/s时,超声弹性成像诊断SS颌下腺病变的曲线下面积(AUC)为0.897,灵敏度为86.4%,特异度为83.0%;当SWV值为2.15 m/s时,超声弹性成像诊断SS腮腺病变的AUC为0.936,灵敏度为93.5%,特异度为86.4%;当SWV值为2.03时,超声弹性成像诊断SS唾液腺病变的AUC为0.959,灵敏度为96.3%,特异度为87.8%。结论超声弹性成像对SS不同腺体病变均有较好的诊断价值。