Dynamic contrast-enhanced ultrasound for differential diagnosis of submandibular gland disease.

Abstract

Intensity-time gradients (ITGs) of contrast-enhanced ultrasound (CEUS) can be used for non-invasive monitoring of gland-preserving treatment effects in sialolithiasis-related chronic sialadenitis as well as for imaging vascularization in tumors. The aim of this clinical trial was to evaluate feasibility to distinguish different entities of submandibular gland disease including inflammatory alterations of the submandibular gland as well as benign and malignant tumors. In this prospective clinical study, ITGs in 30 patients with sialolithiasis-related chronic sialadenitis or an unilateral submandibular mass and 18 disease-free submandibular gland controls were quantitatively analyzed by CEUS using the contrast agent SonoVue. In addition, clinical complaints according to visual analog scales (VAS) were documented. VAS data documented significantly less complaints only in benign tumors compared with the other pathologies of the submandibular gland. In parallel, CEUS-derived ITGs revealed significantly reduced ITGs only in benign tumors (n = 5) compared to the controls (n = 18). Despite of comparably reduced wash-in velocities in malignant lesions (n = 3) statistical significance was not reached. Chronic sialadenitis (n = 18) and its sclerosing variant (Küttner tumor, n = 4) revealed comparable ITGs as controls. Tumors of the submandibular gland present with reduced functional microcirculatory networks comparing with healthy gland controls and chronically inflamed submandibular glands. Thus, dynamic CEUS-derived ITGs in combination with conventional clinical measures--for example VAS--appear as a safe and promising strategy for non-invasive diagnostic workup of submandibular lesions and warrant further validation in a larger set of patients.

• Authors: Sebastian Strieth, Vanessa Siedek, Margarita Rytvina, Robert Gürkov, Alexander Berghaus, Dirk-André Clevert
• Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Eur Arch Otorhinolaryngol) Vol. 271 Issue 1 Pg. 163-9 (Jan 2014) ISSN: 1434-4726 [Electronic] Germany
• PMID: 23625388 (Publication Type: Journal Article)

Chemical References

• Contrast Media

Topics

• Chronic Disease
• Contrast Media
• Diagnosis, Differential
• Feasibility Studies
• Humans
• Image Enhancement
• Microcirculation
• Salivary Gland Calculi (complications, diagnostic imaging)
• Sialadenitis (diagnostic imaging, etiology)
• Submandibular Gland (blood supply)
• Submandibular Gland Neoplasms (diagnostic imaging)
• Ultrasonography, Doppler, Color (methods)