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Objective To investigate the value of diffusion kurtosis imaging (DKI) in differential diagnosis of parotid gland disease and diagnosis of parotid adenolymphoma (PAL).Methods DKI and DWI data of 57 patients with parotid gland disease were etrospectively analyzed.Totally 57 cases were divided into infectious lesions group (n=10),pleomorphic adenoma group (n=19),PAL group (n=14),other benign parotid tumor group (n=4) and malignant parotid tumor group (n=10).Contralateral normal parotid glands in 19 patients with unilateral parotid gland lesions were treated as control group.The quantitative parameters including kurtosis concerning parameters (K Krad,Kax),diffusivity concerning parameters (D Drad,Dax),fractional anisotropy (FA) and conventional apparent diffusion coefficient (ADC) values were retrospectively reviewed.The binary Logistic regression method was used to confirm parameters with significant difference in diagnosing PAL.And Logistic regression equation was constructed to diagnose PAL.ROC analysis was conducted to evaluate the diagnostic value of the confirmed parameters and the Logistic regression equation.Results Significant difference of the parameters including K Krad,Kax,D Drad,Dax,FA and ADC values were found among different groups (all P＜0.05).ROC analysis demonstrated a higher area under the curve (AUC) for FA+Kax [0.88±0.06 (0.79-0.94)] than Kax[0.80±0.07 (0.70-0.88)] and FA [0.63±0.10 (0.52-0.73)],respectively (both P＜0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value was 71.43％,95.78％,91.77％,76.92％ and 94.44％.Conclusion DKI showed high diagnostic capacity in differential diagnosis of parotid gland disease.The combination of FA and Kaxcan improve the diagnostic accuracy in diagnosis of PAL.
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Purpose To evaluate the diagnosis value of real-time ultrasound elastography for differential diagnosis between benign and malignant parotid tumors.Materials and Methods A literature retrieval in PubMed,Embase,High Wire Press,Ovid and CNKI as of May 31,2016 in the English and Chinese languages was conducted.Articles and reviews related to discrimination between benign and malignant parotid gland nodules by means of ultrasound elastography scoring were selected.Pooled sensitivity and specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio as well as summary receiver operating characteristic (ROC) curves were analyzed to evaluate the diagnostic accuracy of ultrasound elasticity scoring.Results A final selection of 7 articles involving 486 nodules in 449 patients was included.Pooled sensitivity and specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio of benign and malignant parotid tumors were 0.781 (95％ CI 0.702-0.847),0.797 (95％ CI 0.750-0.838),3.753 (95％ CI 2.293-6.124),0.285 (95％ CI 0.147-0.555) and 13.941 (95％ CI 4.571-42.519) respectively according to ultrasound elasticity scoring.Area under summary receiver operating characteristic curves was 0.8638 (index Q*=0.7944).Conclusion Real-time ultrasonic elastography has certain diagnostic value in differentiating benign parotid tumors and malignant ones.It can be used as a complement to conventional sonography for improving the diagnostic accuracy of parotid lesions.
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Sialocele formation is a recognised complication of parotid surgery. Most cases resolve after conservative therapy consisting of pressure dressing, fasting, and repeated aspiration. However, some cases are resistent to such treatment and require further intervention. In this report, we present the method of botulinum toxin (BTX) injection into the parotid gland under ultrasonographic guidance along with atropine injection. A 63-year-old female underwent excision of a pleomorphic adenoma abutting an accessory parotid gland. Sialocele formation persisted after almost 3 weeks of conservative therapy. BTX A was given under ultrasonographic guidance and the sialocele disappeared after two doses of treatment. BTX injection under ultrasonographic guidance was thus a safe and effective method for treating persistent sialocele.
Subject(s)
Female , Humans , Middle Aged , Adenoma, Pleomorphic , Atropine , Bandages , Botulinum Toxins , Botulinum Toxins, Type A , Fasting , Methods , Parotid Diseases , Parotid GlandABSTRACT
INTRODUCTION: The location of parotid gland tumors in the superficial or deep lobes can affect the time and difficulty of operations. Therefore, accurate preoperative evaluation of the tumor location is important for surgical outcomes. MATERIALS AND METHODS: A total of 16 patients with parotid gland tumors and who underwent a parotidectomy between April 2003 and March 2011 were retrospectively reviewed in terms of demographic background, tumor location, surgical treatment, and treatment outcomes. Tumor location was estimated by four landmarks on contrast enhanced computerized tomography scans, which were Conn's arc, the facial nerve (FN) line, the Utrecht line, and the retromandibular vein. Tumor location was confirmed by relative position depending on the facial nerve during surgery. It was assumed positive since the tumor lies in the superficial lobe of the parotid gland, the sensitivity, specificity, positive predictive value, negative predictive value, and efficiency of each landmark were evaluated. RESULTS: Our result revealed that the facial nerve line had a sensitivity of 83.3%, specificity of 100%, positive predictive value of 100%, negative predictive value of 71.4%, and efficiency of 87.5%. Some would be more efficient preoperative evaluation methods of the relationship of parotid gland tumors to the facial nerve than others. CONCLUSION: In our study, the FN line was found to be the most reliable analysis method.
Subject(s)
Humans , Facial Nerve , Parotid Diseases , Parotid Gland , Parotid Neoplasms , Retrospective Studies , Sensitivity and Specificity , VeinsABSTRACT
Salivary duct lithiasis is a condition characterized by the obstruction of a salivary gland or its excretory duct due to the formation of calcareous concretions or sialoliths resulting in salivary ectasia and even provoking the subsequent dilation of the salivary gland. It most commonly involves submandibular gland (80 to 90%) and less frequently parotid (10 to 20%). The authors report 2 cases of parotid sialolithiasis. The first case involved a 46-year-old male patient complaining of the left parotid area pain and swelling, and presenting with a salivary calculus in the left parotid duct. When the patient was diagnosed, he refused surgical removal. The second case involved a 41-year-old male patient complaining of the right parotid area pain and swelling, and presenting with a salivary calculus in the right parotid duct. The sialolith was surgically removed under general anesthesia. In this paper, we also reviewed a series of concepts related to the etiology, diagnosis and treatment of sialolithiasis.