Ultrasonography of Parotid and Submandibular Glands in Sjogren's Syndrome

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A total 132 patients were examined at the Department of Oral Surgery in the Dental Hospital of Hokkaido university, from Jan.1988 to Dec.1989.57 patients were diagnosed as definite Sjogren's syndrome(based on diagnostic criteria of the Ministry of Health & Welfare of Japan). 47 were as probable Sjogren's syndrome and 28 as chronic retrograde sialoadenitis.All patients underwent both ultrasonography and sialography, and 61 of them also histopathological inspections. Sonographies of parotid and submandibular glands were graded by heterogeneiy of internal echo. Sialography was classified by Fukuda's classification, and a correlation between ultrasonography and sialography was studied. In histopathology we grouped the cases, according to the grade of lymphocytes infiltration around ducts, and a correlation between ultrasonography and histopathology was investigated.In conclusions (1)In ultramonographic examination of bilateral parotid glands and submandibular glands, "heterogeneity of inte … More rnal echo" was seen in parotid and submandibular glands. And "increase of echo-level", "indistinctness of boundary", "irregularity of margin", "appearance of halo" were seen in submandibular glands. (2)There was a close correlation between heterogeneity in internal echo of the salivary glands and progress of Sjogren's syndrome expressed by sialography. But in some chronic retrograde sialoadenitis light heterogeneity of internal echo was also seen, therefore this echographic feature proved to be not specific to Sjogren's syndrome. However, the echographic features in submandibular glands in Sjogren's syndrome were different from in chronic retrograde sialoadenitis, it suggested the possibility of differential diagnosis. (3)There was a close correlation between heterogeneity in internal echo of the salivary glands and progress of Sjogren's syndrome expressed by histopathological features of parotid glands and labial salivary glands except cases which showed severe heterogeneity in internal echo of salivary glands. Less