Abstract:
Sialography combined with cone beam computerized tomography (sialo-CBCT) is an imaging technique that demonstrates the ductal system of the major salivary glands and allows evaluation of gland function. This review describes the sialo-CBCT technique, terminology, common pitfalls and limitations, as well as radiographic features and suggested pathogenicity of various salivary gland disorders, based on 1,758 sialo-CBCT examinations conducted over the last decade in one institution, and the current literature. The adoption of standardized terminology is proposed to prevent miscommunication, facilitate formulation of differential diagnoses, and thereby promote patient management: (1) Sialo-CBCT requires specific training, and operator experience is required for adequate glandular filling with minimal extravasation; (2) Limit injection-to-scan time to avoid pre-mature emptying; (3) The sialo-CBCT report should include a description of the morphology of the primary duct as well as the secondary, tertiary, and descending branches, the maximal branching level, the presence of sialectasis, overall glandular size, and parenchymal findings; (4) Functional evaluation is based on assessment of iodine clearance in the post evacuation image; (5) Sialectasis and ductopenia are the main findings in Sjogren syndrome and recurrent juvenile parotitis; (6) Sialodochitis with or without fillings defects or hyperdense calcifications characterize obstructive sialadenitis and sialolithiasis; (7) The findings following radioactive-iodine-induced damage are similar to obstructive sialadenitis, with atrophy in late stages; (8) In chronic graft-versus-host disease (cGVHD), variable presentations of ductopenia, sialectasis, and sialodochitis may be evident; (9) The red flags indicating a space-occupying lesion include areas of no filling, splaying of ducts, and primary duct deviation.
摘要:
唾液造影与锥形束计算机断层扫描(sialo-CBCT)相结合是一种成像技术,可显示主要唾液腺的导管系统,并可以评估腺体功能。这篇综述介绍了sialo-CBCT技术,术语,常见的陷阱和局限性,以及各种唾液腺疾病的影像学特征和建议的致病性,根据过去十年在一个机构进行的1,758次sialo-CBCT检查,和当前的文学。建议采用标准化术语来防止误传,促进鉴别诊断的制定,从而促进患者管理:(1)Sialo-CBCT需要特定的培训,和操作者的经验是需要足够的腺体充盈和最小的外渗;(2)限制注射到扫描时间,以避免过早排空;(3)silalo-CBCT报告应包括对一级导管和二级导管形态的描述,tertiary,和下降的分支,最大分支水平,唾液酸的存在,总体腺体大小,和实质发现;(4)功能评估是基于疏散后图像中碘清除率的评估;(5)干燥综合征和复发性青少年腮腺炎的主要发现是唾液腺扩张和导管减少;(6)伴有或不伴有填充物缺陷或高密度钙化的唾液腺炎表现为阻塞性唾液腺炎和梗阻性唾液腺炎;(7)放射性碘引起的损伤后的发现类似于晚期伴有萎缩;(8)在慢性移植物抗宿主病(cGVHD)中,导管减少的可变表现,唾液酸扩张,和唾液腺炎可能是明显的;(9)表明占位性病变的危险信号包括没有充盈的区域,管道张开,和主管道偏差。