【摘要】：目的:探討Ig G4相關(guān)唾液腺病變的超聲聲像圖表現(xiàn),以提高超聲科醫(yī)師對本病的認識。方法:經(jīng)臨床血清學檢驗及組織病理確診(手術(shù)10例,超聲引導(dǎo)下穿刺活檢15例),對25例Ig G4相關(guān)唾液腺病變的超聲聲像圖進行回顧性分析,包括病變腺體的形態(tài)、邊界,內(nèi)部回聲,血流分布,腺管有無擴張,腺管內(nèi)有無結(jié)石,鄰近有無淋巴結(jié)腫大。對比分析14例甾體類藥物治療3個月后的超聲聲像圖改變。結(jié)果:25例Ig G4相關(guān)唾液腺病變患者平均年齡64.5歲,男女比例4∶1。病變位于下頜下腺(20例)、腮腺(5例)。超聲表現(xiàn):1彌漫性改變10例(9例雙側(cè),1例單側(cè)),形態(tài)飽滿,腺體回聲偏低,呈網(wǎng)格狀改變,3例腺管擴張,2例伴腺管內(nèi)結(jié)石,彩色多普勒顯示唾液腺腺體內(nèi)血管增多,血流豐富;2局灶性改變15例(14例單側(cè),1例雙側(cè)),呈不均質(zhì)偏低回聲"腫塊","腫塊"內(nèi)血流呈放射狀分布。3下頜下淋巴結(jié)病變8例,4例經(jīng)穿刺確診,4例疑似。4甾體類藥物治療后,腫大的唾液腺逐漸恢復(fù),局灶性病灶逐漸變小,病變內(nèi)血流分布減少。結(jié)論:認識Ig G4相關(guān)唾液腺病變的超聲圖像表現(xiàn),可以有效輔助臨床診斷與治療后隨訪,避免不必要的手術(shù)風險。
[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.
【作者單位】： 解放軍總醫(yī)院南樓臨床部超聲科;
【分類號】：R445.1;R781.7

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