Comparison of the Inadequacies of Ultrasonography and Computed Tomography in the Diagnosis of Sialolithiasis.

Necdet Özçelik, Husam Vehbi, Elvin Alaskarov
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Abstract

This study aimed to determine the value of either ultrasonography and computed tomography (CT) alone or both for diagnosing salivary gland stones. Based on their clinical findings and physical examination, 188 patients with salivary stones were included. Initially, an ultrasound was performed, and then a non-contrast-enhanced thin-sliced CT scan was done. The study included 161 patients with suspected submandibular gland (SMG) sialolithiasis and 27 with parotid gland (PG) sialolithiasis. Among the SMG cases, stones were confirmed in 130 patients through interventional sialoendoscopy. Sixteen of the stones were detected by CT scan only and were not seen in the previous ultrasound examination. After the second follow-up ultrasound, which was conducted after reviewing the CT scans, 9 of them were identified. Five patients with distal stones and ductal dilation on ultrasound were confirmed to have sialolithiasis. In 5 patients with stones detected on ultrasound but not on CT, dental filling artifacts were identified as the cause. For PG cases, stones were observed in 18 out of 19 patients with suspected sialolithiasis based on ultrasound and CT findings. Three patients with positive CT findings but negative ultrasound showed stones during sialendoscopy. During an ultrasound examination, palpating the floor of the mouth with the other hand's index finger can help identify stones obscured by the shadow of the mandible, thereby enhancing the test's accuracy. Patients with dental fillings, implants, and permanent dentures should not be referred for a CT scan to avoid unnecessary exposure to ionizing radiation. They also cause significant metallic artifacts in the field of interest. In these cases, ultrasound should be considered. To minimize the effects of ionizing radiation, it is recommended to create limited field requests for the target, focusing solely on the submandibular and PGs.

比较超声波和计算机断层扫描在诊断霰粒肿方面的不足。
本研究旨在确定单独使用超声波和计算机断层扫描(CT)或同时使用这两种方法诊断唾液腺结石的价值。根据临床表现和体格检查结果,188 名唾液腺结石患者被纳入研究范围。首先进行超声波检查,然后进行非造影剂增强薄层 CT 扫描。研究包括161例疑似颌下腺(SMG)涎结石患者和27例腮腺(PG)涎结石患者。在 SMG 病例中,130 名患者通过介入性咽内镜检查确诊为结石。其中 16 例结石仅通过 CT 扫描发现,在之前的超声波检查中未见结石。在复查 CT 扫描后进行的第二次超声波随访检查中,发现了其中 9 个结石。5 名超声波检查发现远端结石和导管扩张的患者被证实患有霰粒肿。在 5 名超声波检查发现结石但 CT 检查未发现结石的患者中,牙科填充物伪影被确定为结石的原因。在 PG 病例中,根据超声波和 CT 检查结果怀疑患有霰粒肿的 19 名患者中有 18 人发现了结石。3 名 CT 检查结果呈阳性但超声检查结果呈阴性的患者在巩膜内窥镜检查中发现了结石。在进行超声波检查时,用另一只手的食指触摸口腔底部有助于识别被下颌骨阴影遮挡的结石,从而提高检查的准确性。有牙科补牙、植入物和永久假牙的患者不应转诊进行 CT 扫描,以避免不必要地暴露于电离辐射中。补牙、植入物和永久性假牙也会在扫描范围内造成明显的金属伪影。在这种情况下,应考虑超声波检查。为尽量减少电离辐射的影响,建议对目标进行有限的视野要求,只关注颌下腺和 PG。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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