Ultrasonography of Parotid and Submandibular Glands in Sjogren's Syndrome

1988年1月至1989年12月，在北海道大学牙科医院口腔外科对132例患者进行了检查，其中57例患者被诊断为明确的干燥综合征（根据日本卫生和福利部的诊断标准）。47例疑似干燥综合征，28例疑似慢性退行性涎腺炎。所有患者均行超声和唾液造影检查，其中61例还行组织病理学检查。腮腺及下颌骨超声检查以内回声的不均匀性分级。采用福田分类法对涎腺造影进行分类，并探讨超声与涎腺造影的相关性。在组织病理学方面，我们根据淋巴管周围淋巴细胞浸润的程度对病例进行分组，并探讨超声检查与组织病理学的相关性。结论(1)双侧腮腺及颌下腺超声检查中，腮腺及颌下腺“整体不均匀，回声较多”。颌下腺可见“回声水平增高”、“边界不清”、“边缘不规则”、“晕状影”。(2)唾液腺内回声的异质性与涎腺造影表达的干燥综合征的进展密切相关。但在一些慢性逆行性涎腺炎中，也可见到内部回声的光异质性，因此这种超声特征被证明不是干燥综合征所特有的。然而，干燥综合征颌下腺的超声表现与慢性退行性涎腺炎不同，提示鉴别诊断的可能性。(3)唾液腺内回声的异质性与腮腺和唇唾液腺组织病理学特征所表达的干燥综合征的进展密切相关，但唾液腺内回声异质性严重的病例除外。少

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