超声检查在IgG4相关唾液腺病变诊断中的应用

发布时间：2018-10-22 13:34

【摘要】：目的:探讨Ig G4相关唾液腺病变的超声声像图表现,以提高超声科医师对本病的认识。方法:经临床血清学检验及组织病理确诊(手术10例,超声引导下穿刺活检15例),对25例Ig G4相关唾液腺病变的超声声像图进行回顾性分析,包括病变腺体的形态、边界,内部回声,血流分布,腺管有无扩张,腺管内有无结石,邻近有无淋巴结肿大。对比分析14例甾体类药物治疗3个月后的超声声像图改变。结果:25例Ig G4相关唾液腺病变患者平均年龄64.5岁,男女比例4∶1。病变位于下颌下腺(20例)、腮腺(5例)。超声表现:1弥漫性改变10例(9例双侧,1例单侧),形态饱满,腺体回声偏低,呈网格状改变,3例腺管扩张,2例伴腺管内结石,彩色多普勒显示唾液腺腺体内血管增多,血流丰富;2局灶性改变15例(14例单侧,1例双侧),呈不均质偏低回声"肿块","肿块"内血流呈放射状分布。3下颌下淋巴结病变8例,4例经穿刺确诊,4例疑似。4甾体类药物治疗后,肿大的唾液腺逐渐恢复,局灶性病灶逐渐变小,病变内血流分布减少。结论:认识Ig G4相关唾液腺病变的超声图像表现,可以有效辅助临床诊断与治疗后随访,避免不必要的手术风险。
[Abstract]:Objective: to investigate the sonographic features of Ig G 4 associated salivary gland lesions in order to improve the recognition of this disease. Methods: by clinical serological examination and histopathological diagnosis (10 cases of operation and 15 cases of ultrasound-guided biopsy), the ultrasonographic features of 25 cases of salivary gland lesions associated with Ig G4 were retrospectively analyzed, including the shape and boundary of the lesions. Internal echo, blood flow distribution, dilatation of glandular duct, stone in glandular duct, lymph node enlargement in adjacent region. The sonographic changes of 14 cases of steroid drugs after 3 months treatment were compared. Results: the average age of 25 patients with Ig G4 associated salivary gland lesions was 64. 5 years old, and the ratio of male to female was 4: 1. The lesions were located in the submandibular gland (20 cases) and parotid gland (5 cases). Sonographic findings: 1 diffuse changes were found in 10 cases (9 bilateral, 1 unilateral), with full shape, low glandular echo, reticular changes, 3 adenomatous tube dilatation, 2 intraductal stones, and increased intraglandular vessels in salivary glands by color Doppler imaging (CDFI). (2) Local changes were found in 15 cases (14 unilateral and 1 bilateral), with heterogeneous hypoechoic "mass" and radial distribution of blood flow in "mass". 3 among 8 cases of submandibular lymphadenopathy, 4 cases were diagnosed by puncture, 4 cases were suspected to be treated with steroid drugs, 4 cases were diagnosed by puncture, 4 cases were suspected to be treated with steroidal drugs, 3 cases had submandibular lymph node lesions, 4 cases were diagnosed by puncture, 4 cases were suspected. The enlarged salivary glands gradually recovered, the focal lesions gradually became smaller, and the distribution of blood flow in the lesions decreased. Conclusion: to recognize the ultrasonographic features of salivary gland lesions associated with Ig G4 can effectively assist clinical diagnosis and follow up after treatment and avoid unnecessary surgical risks.
【作者单位】：解放军总医院南楼临床部超声科;
【分类号】：R445.1;R781.7

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