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Tanaka T, Oda M, Wakasugi-Sato N, Joujima T, Miyamura Y, Habu M, Kodama M, Takahashi O, Sago T, Matsumoto-Takeda S, Nishida I, Tsurushima H, Otani Y, Yoshiga D, Sasaguri M, Morimoto Y. First Report of Sublingual Gland Ducts: Visualization by Dynamic MR Sialography and Its Clinical Application. J Clin Med 2020; 9:jcm9113676. [PMID: 33207659 PMCID: PMC7698194 DOI: 10.3390/jcm9113676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 01/26/2023] Open
Abstract
This study was done to determine whether the sublingual gland ducts could be visualized and/or their function assessed by MR sialography and dynamic MR sialography and to elucidate the clinical significance of the visualization and/or evaluation of the function of sublingual gland ducts by clinical application of these techniques. In 20 adult volunteers, 19 elderly volunteers, and 7 patients with sublingual gland disease, morphological and functional evaluations were done by MR sialography and dynamic MR sialography. Next, four parameters, including the time-dependent changes (change ratio) in the maximum area of the detectable sublingual gland ducts in dynamic MR sialographic images and data were analyzed. Sublingual gland ducts could be accurately visualized in 16 adult volunteers, 12 elderly volunteers, and 5 patients. No significant differences in the four parameters in detectable duct areas of sublingual glands were found among the three groups. In one patient with a ranula, the lesion could be correctly diagnosed as a ranula by MR sialography because the mass was clearly derived from sublingual gland ducts. This is the first report of successful visualization of sublingual gland ducts. In addition, the present study suggests that MR sialography can be more useful in the diagnosis of patients with lesions of sublingual gland ducts.
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Affiliation(s)
- Tatsurou Tanaka
- Division of Oral and Maxillofacial Radiology, Kyushu Dental University, Kitakyushu 803-8580, Japan; (T.T.); (M.O.); (N.W.-S.); (T.J.); (Y.M.); (S.M.-T.)
| | - Masafumi Oda
- Division of Oral and Maxillofacial Radiology, Kyushu Dental University, Kitakyushu 803-8580, Japan; (T.T.); (M.O.); (N.W.-S.); (T.J.); (Y.M.); (S.M.-T.)
| | - Nao Wakasugi-Sato
- Division of Oral and Maxillofacial Radiology, Kyushu Dental University, Kitakyushu 803-8580, Japan; (T.T.); (M.O.); (N.W.-S.); (T.J.); (Y.M.); (S.M.-T.)
| | - Takaaki Joujima
- Division of Oral and Maxillofacial Radiology, Kyushu Dental University, Kitakyushu 803-8580, Japan; (T.T.); (M.O.); (N.W.-S.); (T.J.); (Y.M.); (S.M.-T.)
| | - Yuichi Miyamura
- Division of Oral and Maxillofacial Radiology, Kyushu Dental University, Kitakyushu 803-8580, Japan; (T.T.); (M.O.); (N.W.-S.); (T.J.); (Y.M.); (S.M.-T.)
| | - Manabu Habu
- Division of Maxillofacial Surgery, Kyushu Dental University, Kitakyushu 803-8580, Japan; (M.H.); (O.T.); (M.S.)
| | - Masaaki Kodama
- Department of Oral and Maxillofacial Surgery, Japan Seafarers Relief Association Moji Ekisaikai Hospital, Kyushu 801-8550, Japan;
| | - Osamu Takahashi
- Division of Maxillofacial Surgery, Kyushu Dental University, Kitakyushu 803-8580, Japan; (M.H.); (O.T.); (M.S.)
| | - Teppei Sago
- Division of Dental Anesthesiology, Kyushu Dental University, Kitakyushu 803-8580, Japan;
| | - Shinobu Matsumoto-Takeda
- Division of Oral and Maxillofacial Radiology, Kyushu Dental University, Kitakyushu 803-8580, Japan; (T.T.); (M.O.); (N.W.-S.); (T.J.); (Y.M.); (S.M.-T.)
| | - Ikuko Nishida
- Division of Developmental Stomatognathic Function Science, Kyushu Dental University, Kitakyushu 803-8580, Japan;
| | - Hiroki Tsurushima
- Division of Oral Medicine, Kyushu Dental University, Kitakyushu 803-8580, Japan; (H.T.); (Y.O.); (D.Y.)
| | - Yasushi Otani
- Division of Oral Medicine, Kyushu Dental University, Kitakyushu 803-8580, Japan; (H.T.); (Y.O.); (D.Y.)
| | - Daigo Yoshiga
- Division of Oral Medicine, Kyushu Dental University, Kitakyushu 803-8580, Japan; (H.T.); (Y.O.); (D.Y.)
| | - Masaaki Sasaguri
- Division of Maxillofacial Surgery, Kyushu Dental University, Kitakyushu 803-8580, Japan; (M.H.); (O.T.); (M.S.)
| | - Yasuhiro Morimoto
- Division of Oral and Maxillofacial Radiology, Kyushu Dental University, Kitakyushu 803-8580, Japan; (T.T.); (M.O.); (N.W.-S.); (T.J.); (Y.M.); (S.M.-T.)
- Correspondence: ; Tel./Fax: +81-93-285-3094
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Abstract
Summary
Backround/Aim: Stafne bone cavity which is also known as lingual mandibular bone defect is generally seen in the posterior region of the mandible. Stafne bone defects of the anterior mandible are very rare, with around 50 cases reported in the English literature. They are generally asymptomatic and incidental lesion findings may be diagnosed during a radiographic examination.
Case Report: A 59 year-old female patient was examined for dental complaints. Panoramic radiography revealed a unilocular lesion at the left incisor- premolar area. Dental volumetric tomography scans showed a concavity at the lingual side of the related area. Magnetic resonance imaging was suggested for possible soft tissue pathology and, depending on MRI finding, the cavity was initially diagnosed as Stafne bone defect.
Conclusion: The aim of this case report is to describe an unusually located Stafne bone cavity with special emphasis to the need of using special imaging modalities.
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Fukumoto W, Higaki T, Matsuoka Y, Tatsugami F, Baba Y, Iida M, Awai K. Quantification of the salivary volume flow rate in the parotid duct using the time‐spatial labeling inversion pulse (Time‐SLIP) technique at MRI: A feasibility study. J Magn Reson Imaging 2017; 47:928-935. [DOI: 10.1002/jmri.25846] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/14/2017] [Indexed: 01/07/2023] Open
Affiliation(s)
- Wataru Fukumoto
- Department of Diagnostic RadiologyInstitute of Biomedical Health Sciences, Hiroshima UniversityHiroshima Japan
| | - Toru Higaki
- Department of Diagnostic RadiologyInstitute of Biomedical Health Sciences, Hiroshima UniversityHiroshima Japan
| | - Yoshiko Matsuoka
- Department of Diagnostic RadiologyHiroshima University HospitalHiroshima Japan
| | - Fuminari Tatsugami
- Department of Diagnostic RadiologyInstitute of Biomedical Health Sciences, Hiroshima UniversityHiroshima Japan
| | - Yasutaka Baba
- Department of Diagnostic RadiologyInstitute of Biomedical Health Sciences, Hiroshima UniversityHiroshima Japan
| | - Makoto Iida
- Department of Diagnostic RadiologyInstitute of Biomedical Health Sciences, Hiroshima UniversityHiroshima Japan
| | - Kazuo Awai
- Department of Diagnostic RadiologyInstitute of Biomedical Health Sciences, Hiroshima UniversityHiroshima Japan
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Modern management of juvenile recurrent parotitis. The Journal of Laryngology & Otology 2012; 126:1254-60. [DOI: 10.1017/s0022215112002319] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractAims:To evaluate modern diagnostic and therapeutic management of juvenile recurrent parotitis, and to show the benefits of operative sialoendoscopy on the basis of our experience in 14 patients and the results of others.Results:Ultrasonography is sensitive in detecting the pathological features of juvenile recurrent parotitis. Interventional sialoendoscopy is a safe and effective method of treating the disease. In our case series, after a mean follow-up time of 30 months only 5 patients experienced recurrence of symptoms, with a mean symptom-free period of 20 months.Conclusion:The use of modern, minimally invasive diagnostic tools such as colour Doppler ultrasonography, magnetic resonance sialography and sialoendoscopy represents a new frontier in the management of juvenile recurrent parotitis. Operative sialoendoscopy also has the important therapeutic benefit of reducing the number of recurrences of acute episodes of parotitis, thus giving patients a better quality of life until puberty.
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Abstract
Lingual mandibular bone defect, also known as Stafne bone cavity, is mostly seen in the posterior portion of the mandible. Inclusions in the anterior portion are very unusual, with around 50 cases reported in the English-language literature. They are often asymptomatic conditions diagnosed during a routine radiographic examination. This article describes a case of anterior Stafne bone cavity in a 52-year-old man mistaken for periapical pathologic defect and referred for treatment. In addition to clinical examination, the patient was imaged using conventional periapical, panoramic radiography, and computed tomography. Confirmation of the salivary gland tissue in the lingual mandibular defect was made with the histopathologic examination after surgical intervention. The differential diagnoses, treatment choices, and pathogenesis of these bone cavities are also discussed after the case presentation along with the literature review.
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Affiliation(s)
- Kıvanc Turkoglu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Kopeć T, Wierzbicka M, Szyfter W. [Reconstruction of dissected Stensen's duct after facelift surgery]. Otolaryngol Pol 2010; 64:215-8. [PMID: 20873096 DOI: 10.1016/s0030-6657(10)70018-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Rejuvenation procedures, especially facelift are nowadays common type of cosmetic surgery. According to the statistical data, facelifts were the seventh most popular aesthetic surgery performed after liposuction, breast augmentation, blepharoplasty (eyelid surgery), abdominoplasty (tummy tuck), breast reduction and rhinoplasty. The most common complication after surgery is bleeding. Less common, but potentially serious, complications may include damage to the facial nerves and necrosis of the skin flaps, infection and damage of parotid duct. We present a case of 50 years old woman, who has undergone facelift surgery with damage of parotid duct and consequently formation of sialocele. Localisation of damage and repair of dissected Stensen's duct was performed using external approach. The duct was sutured end to end using intraductal stent. After 3 weeks stent was removed. We observed normal saliva flow from natural orifice of parotid gland.
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Affiliation(s)
- Tomasz Kopeć
- Klinika Otolaryngologii i Onkologii Laryngologicznej UM im. Karola Marcinkowskiego w Poznaniu
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Fritsch MH. Sialendoscopy and Lithotripsy: Literature Review. Otolaryngol Clin North Am 2009; 42:915-26, Table of Contents. [DOI: 10.1016/j.otc.2009.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Habu M, Tanaka T, Tomoyose T, Ono K, Anzai T, Ozaki Y, Yoshioka I, Yamashita Y, Kodama M, Yamamoto N, Oda M, Wakasugi N, Matsumoto S, Takahashi T, Inenaga K, Tominaga K, Morimoto Y. Significance of dynamic magnetic resonance sialography in prognostic evaluation of saline solution irrigation of the parotid gland for the treatment of xerostomia. J Oral Maxillofac Surg 2009; 68:768-76. [PMID: 19913967 DOI: 10.1016/j.joms.2009.04.110] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2009] [Accepted: 04/23/2009] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the clinical significance of dynamic magnetic resonance (MR) sialographic images in prognostic evaluation of saline solution irrigation of the parotid gland for the treatment of xerostomia. MATERIALS AND METHODS Morphologic findings and functional parameters were evaluated by use of dynamic MR sialography before saline solution irrigation of the parotid gland for the treatment of xerostomia in 17 patients. In addition, the MR sialographic data before the saline solution irrigation treatment in patients with improvement of salivary secretion and the sensation of dry mouth after irrigation treatment were compared with data in patients without improvement. RESULTS The maximum changing ratio in the group of patients with improvement after treatment was significantly higher (P = .042) than that in the group of patients without improvement. In addition, high correlations were found between the changing ratio and improvement on the visual analog scale for dry mouth sensation after treatment (Pearson r = 0.63, P = .001) and improvement of salivary flow rate (Pearson r = 0.77, P = .001). Moreover, in 12 patients with improvement of salivary flow rate after the saline solution irrigation treatment, the maximum changing ratio before the saline solution irrigation treatment was over 1.2. However, no significant differences in other parameters, including the detectable ductal area, were found between the group of patients with improvement after treatment and the group without improvement. CONCLUSIONS Our study suggests that dynamic MR sialography might be useful for the prognostic evaluation of saline solution irrigation of the parotid gland for the treatment of xerostomia.
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Affiliation(s)
- Manabu Habu
- Department of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Science, Kyushu Dental College, Kitakyushu, Japan
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10
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Su YX, Feng ST, Liao GQ, Zhong YQ, Liu HC, Zheng GS. CT virtual sialendoscopy versus conventional sialendoscopy in the visualization of salivary ductal lumen: an in vitro study. Laryngoscope 2009; 119:1339-43. [PMID: 19507221 DOI: 10.1002/lary.20504] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS To evaluate the feasibility of computed tomographic (CT) virtual sialendoscopy and its performance characteristics for the visualization of salivary ductal lumen as compared with conventional sialendoscopy. STUDY DESIGN An in vitro study. METHODS Conventional sialendoscopy was performed in 16 submandibular glands in vitro and the surgical findings were recorded. Then a contrast agent was injected into the Wharton's duct via orifice. After CT scanning, the CT data were transferred to an independent workstation and were postprocessed with commercially available software to generate three-dimensional reconstructive and virtual sialendoscopic images. Finally, the plastination of submandibular glands was performed with 20% perchloroethylene ethyl acetate plastics filler to make cast specimens. CT three-dimensional reconstruction of the ductal system was compared with the cast specimen, and the performance of conventional sialendoscopy and CT virtual sialendoscopy for the visualization of salivary ductal lumen was also compared. RESULTS The CT data acquisition and postprocessing protocol were feasible. CT three-dimensional reconstruction enabled clear visualization of the ductal system from any directions and angles, which showed close resemblance to the cast specimens. And CT virtual sialendoscopy created clear endoluminal views of salivary ducts simulating those obtained with conventional sialendoscopy. CONCLUSIONS Our initial experience shows that CT virtual sialendoscopy has the potential to be an attractive imaging technique for the visualization of salivary ductal lumen.
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Affiliation(s)
- Yu-xiong Su
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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Capaccio P, Cuccarini V, Ottaviani F, Minorati D, Sambataro G, Cornalba P, Pignataro L. Comparative Ultrasonographic, Magnetic Resonance Sialographic, and Videoendoscopic Assessment of Salivary Duct Disorders. Ann Otol Rhinol Laryngol 2008; 117:245-52. [DOI: 10.1177/000348940811700402] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: Salivary duct disorders are the second most common cause of obstruction after calculi. Magnetic resonance sialography has been recently proposed as a means of diagnosing a heterogeneous group of salivary disorders, and so we compared it with sialoendoscopy in evaluating stenoses and sialectasia in 24 patients with obstructive symptoms and ultrasonographic results negative for calculi or masses. Methods: All of the patients (19 of whom had recurrent unilateral or bilateral swollen parotid glands and 5 of whom also had recurrent swollen submandibular glands) underwent dynamic color Doppler ultrasonography and dynamic magnetic resonance sialography with lemon juice stimulation of saliva; 18 patients also underwent diagnostic sialoendoscopy. Results: Ultrasonography and color Doppler ultrasonography showed duct dilatation in all patients (bilateral in 5 with parotid stenosis). Magnetic resonance sialography confirmed duct dilatation and stenosis in all of the patients, and revealed the simultaneous presence of calculi in 4 cases. A parotid sialocele was found in 4 cases. The magnetic resonance sialographic findings were confirmed in the patients who underwent sialoendoscopy. No side effects were observed. Conclusions: Magnetic resonance sialography following prediagnostic ultrasonography allows an adequate diagnosis of salivary duct disorders such as stenosis and sialectasia, as confirmed by objective sialoendoscopic assessment. Magnetic resonance sialography also makes it possible to visualize the salivary duct system up to its tertiary branches and, in this regard, may be considered a valid, noninvasive method for the evaluation of salivary duct disorders.
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Koch M, Zenk J, Iro H. Speichelgangsendoskopie in der Diagnostik und Therapie von obstruktiven Speicheldrüsenerkrankungen. HNO 2007; 56:139-44. [PMID: 17676291 DOI: 10.1007/s00106-007-1563-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In 5-10% of all cases with an obstructive disease of the major salivary glands, a diagnosis cannot be established by conventional radiological imaging or ultrasound. Using sialendoscopes, intraductal pathology can made visible to the surgeon, aiding in diagnosis and adequate treatment. MATERIAL AND METHODS Between 2001 and 2005, 369 sialoscopies were performed on 318 patients in the ENT department of the University of Erlangen-Nuremberg. Semi-rigid sialoscopes with an external diameter of between 0.7 and 1.7 mm were used. RESULTS In 34.9% of cases conservative treatment was necessary. In 65.1%, based on the sialoscopic findings, further therapeutic procedures such as extracorporeal shock wave lithotripsy, interventional sialoscopy or duct slitting were required and planned. Of 133 performed interventional sialoscopies, 83.5% were successful. CONCLUSIONS Sialoscopy is a useful diagnostic and therapeutic tool in obstructive salivary gland disease. Interventional sialoscopy has been performed with high success rates and has proven to be an important part in our concept of a gland preserving therapeutic regime.
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Affiliation(s)
- M Koch
- Hals- Nasen-, Ohrenklinik, Kopf- und Hals-Chirurgie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstrasse 1, 91054 Erlangen.
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Smith MH, Brooks SL, Eldevik OP, Helman JI. Anterior mandibular lingual salivary gland defect: A report of a case diagnosed with cone-beam computed tomography and magnetic resonance imaging. ACTA ACUST UNITED AC 2007; 103:e71-8. [PMID: 17331754 DOI: 10.1016/j.tripleo.2006.11.044] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2006] [Revised: 11/22/2006] [Accepted: 11/23/2006] [Indexed: 11/24/2022]
Abstract
Anterior mandibular lingual salivary gland defects are rare. They may be evident on routine radiographic exam. Because the differential diagnosis can be exhaustive, differential interpretation and diagnosis are crucial. A case of large bilateral radiolucent lesions of the anterior mandible that was an anterior mandibular salivary gland defect is reported in a young female. This lesion was initially visualized on a panoramic radiograph. Further evaluation was undertaken with dental cone-beam computed tomography. Confirmation of bilateral anterior mandibular lingual salivary gland defects was made using magnetic resonance imaging, negating the need for surgical biopsy.
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Affiliation(s)
- Miller H Smith
- Resident, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-0018, USA.
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Morimoto Y, Konoo T, Tominaga K, Tanaka T, Yamaguchi K, Fukuda JI, Ohba T. Relationship between cortical bone formation on mandibular condyles and alternation of the magnetic resonance signals characteristic of growth. Am J Orthod Dentofacial Orthop 2007; 131:473-80. [PMID: 17418713 DOI: 10.1016/j.ajodo.2005.01.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2004] [Revised: 01/01/2005] [Accepted: 01/01/2005] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The purpose of this study was to elucidate the significance of double contour-like structures (DCLS) relative to the maturity of mandibular condyles and the possible constituents of DCLS. We evaluated the relationship between the alternation of DCLS and the ossification on the top of mandibular condyles. METHODS In 36 subjects, aged 9 to14 years at the first examination, magnetic resonance imaging characteristics of the mandibular condyles were obtained from fast spin echo intermediate-weighted images and T2-weighted images; 2 or 3 years later, magnetic resonance images were again obtained from 23 of the same 36 subjects. RESULTS A significant relationship was found between the absence of DCLS and the continuity of void-signal lines on the tops of the mandibular condyles. DCLS disappeared, and the void-signal lines on the tops of the mandibular condyles became continuous as the children grew. The top of DCLS was seen as a hypersignal on T2-weighted images. CONCLUSIONS Alternations of DCLS might be a useful criterion for evaluating the maturity of mandibular condyles in children. Possible constituents of DCLS might be hypervascular loose fibrous tissue and a proliferation of cartilage accompanied by active ossification on the tops of the mandibular condyles.
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Affiliation(s)
- Yasuhiro Morimoto
- Department of Dental Radiology, Kyushu Dental College, Kitakyushu, Japan.
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Abstract
Inflammatory conditions are the most common pathology to affect the salivary glands, of which sialolithiasis is the most frequent etiology. This article reviews the role of all imaging modalities in the management of inflammatory salivary disease. The technique for performing salivary gland ultrasound is described with some common pitfalls. The typical features of a comprehensive range of pathology including obstructive and infective sialadenitis, Sjogren's syndrome, sarcoidosis, HIV sialopathy, and their complications are described.
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Affiliation(s)
- Gitta Madani
- Royal National Throat, Nose, and Ear Hospital, London, United Kingdom
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Su YX, Liao GQ, Kang Z, Zou Y. Application of Magnetic Resonance Virtual Endoscopy as a Presurgical Procedure Before Sialoendoscopy. Laryngoscope 2006; 116:1899-906. [PMID: 17003703 DOI: 10.1097/01.mlg.0000235919.94393.c6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objectives of this study were to investigate the feasibility of clinical application of magnetic resonance (MR) virtual endoscopy as a presurgical procedure before sialoendoscopy and to evaluate its value in the diagnosis of obstructive salivary gland diseases and preoperative visualization of endoluminal views. STUDY DESIGN This study presents our initial experience to use MR virtual endoscopy for the presurgical visualization of salivary duct lumen and ductal pathologies in comparison to the sialoendoscopy findings in a feasibility study. METHODS Six consecutive patients with suspected obstructive salivary gland diseases underwent MR sialography with a three-dimensional fast imaging using steady-state acquisition. The three-dimensional MR data were transferred to an independent workstation and were postprocessed with navigator software to generate three-dimensional reconstruction and virtual endoscopic images. The fly-through mode was used to imitate the sialoendoscopic exploratory procedure. Then the patients underwent sialoendoscopy and the endoscopic findings were compared with the preoperative virtual endoscopic images. RESULTS The MR data acquisition and postprocessing protocol were feasible. The virtual endoscopy created clear endoluminal views of salivary duct and the ductal pathologies. The diagnoses were all confirmed by surgical sialoendoscopy. The virtual endoscopic images showed close resemblance to the sialoendoscopic findings. CONCLUSIONS MR virtual endoscopy is an effective and noninvasive diagnostic method for evaluating the endoluminal anatomy and pathologies of the salivary duct. The clinical application of MR virtual endoscopy as a presurgical procedure before sialoendoscopy is a valuable and promising approach, which can provide surgeons useful morphologic and pathologic information.
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Affiliation(s)
- Yu-Xiong Su
- Department of Oral and Maxillofacial Surgery, Guanghua College of Stomatology, Sun Yat-sen University, Guangzhou, PR China
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Morimoto Y, Habu M, Tomoyose T, Ono K, Tanaka T, Yoshioka I, Tominaga K, Yamashita Y, Ansai T, Kito S, Okabe S, Takahashi T, Takehara T, Fukuda J, Inenaga K, Ohba T. Dynamic magnetic resonance sialography as a new diagnostic technique for patients with Sjogren's syndrome. Oral Dis 2006; 12:408-14. [PMID: 16792727 DOI: 10.1111/j.1601-0825.2005.01215.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the clinical utility of dynamic magnetic resonance (MR) sialographic images as a diagnostic tool for patients with Sjögren's syndrome. METHODS The morphological findings and various kinds of functional parameters in volunteers on dynamic MR sialographic images were compared with those in five patients with definite Sjögren's syndrome. RESULTS On the MR sialographs of all five patients with Sjögren's syndrome, the so-called 'apple-tree appearance' was seen. The difference in two functional parameters using the dynamic MR sialographic data was elucidated between the two groups. The maximum area of the detectable ducts in the group of patients was significantly smaller (P < 0.001) than that in the group of volunteers. The ratio of change in the detectable ducts in the group of patients was significantly lower (P = 0.011) than that in the group of volunteers. CONCLUSIONS Our study suggests that dynamic MR sialographic data in addition to MR sialographic images might be useful for the diagnosis of Sjögren's syndrome.
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Affiliation(s)
- Y Morimoto
- Division of Diagnostic Radiology, Department of Oral Diagnostic Science, Kyushu Dental College, Kitakyushu, Fukuoka, Japan.
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Ono K, Morimoto Y, Inoue H, Masuda W, Tanaka T, Inenaga K. Relationship of the unstimulated whole saliva flow rate and salivary gland size estimated by magnetic resonance image in healthy young humans. Arch Oral Biol 2006; 51:345-9. [PMID: 16219291 DOI: 10.1016/j.archoralbio.2005.09.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2005] [Revised: 09/01/2005] [Accepted: 09/02/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aim of this study was to examine the relationships between gland sizes and the flow rate and composition of the unstimulated whole saliva in humans. DESIGN In 28 healthy young adults, the sizes of the three major salivary glands were estimated by use of a magnetic resonance (MR) imaging technique. Unstimulated whole saliva was collected for 5 min by the spitting method, and the flow rate and the concentrations of total protein, Na(+) and K(+) and pH were measured. RESULTS The estimated sizes of the parotid and submandibular glands showed a significant positive correlation with the flow rate and the secretion rate of total protein in the unstimulated whole saliva, but that of the sublingual glands did not. Concerning the concentrations of Na(+) and K(+) and pH, there were no correlations with the salivary gland sizes. CONCLUSIONS The results suggest that the larger the sizes of the parotid and submandibular glands, the faster the fluid flow and protein secretion rates in unstimulated whole saliva.
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Affiliation(s)
- Kentaro Ono
- Department of Biosciences, Kyushu Dental College, 2-6-1 Manazuru, Kokurakitaku, Kitakyushu, 803-8580, Japan
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Morimoto Y, Ono K, Tanaka T, Kito S, Inoue H, Shinohara Y, Yokota M, Inenaga K, Ohba T. The functional evaluation of salivary glands using dynamic MR sialography following citric acid stimulation: a preliminary study. ACTA ACUST UNITED AC 2006; 100:357-64. [PMID: 16122666 DOI: 10.1016/j.tripleo.2004.11.053] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2004] [Revised: 09/20/2004] [Accepted: 11/29/2004] [Indexed: 12/19/2022]
Abstract
OBJECTIVE We introduce a new technique for the functional evaluation of the salivary glands using continuous magnetic resonance (MR) sialography before and after citric acid stimulation. METHODS In 10 volunteers, the time-dependent changes in the maximum area of the detectable parotid gland ducts on MR sialographic images taken every 30 seconds before and after citric acid stimulation were analyzed. The time period to the occurrence of the maximum duct area poststimulation was noted, and then the time for the area to return to its 50% value pre-citric acid stimulation was also observed. This new technique was clinically applied in 1 patient with an excessive supply impression of saliva and in 1 patient with a short supply impression with saliva. RESULTS In all volunteers after citric acid stimulation, the maximum area of the detectable salivary gland ducts first increased and then decreased. A strong relationship was found between the maximum area of the detectable salivary gland ducts before citric acid stimulation and total saliva volume (Pearson r = 0.672, P = .031). Compared with all the volunteers, the ratio of change in the detectable ducts was the highest in the patient with an excessive supply impression of saliva, but lowest in the patient with a short supply impression with saliva. CONCLUSIONS This initial study suggests that dynamic MR sialography allows for functional and morphological evaluation of the salivary glands. This technique appears to have many possible applications and further investigation in this field is necessary.
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Affiliation(s)
- Yasuhiro Morimoto
- Department of Dental Radiology, Kyushu Dental College, Kitakyushu, Japan.
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Tanaka T, Morimoto Y, Shiiba S, Sakamoto E, Kito S, Matsufuji Y, Nakanishi O, Ohba T. Utility of magnetic resonance cisternography using three-dimensional fast asymmetric spin-echo sequences with multiplanar reconstruction: the evaluation of sites of neurovascular compression of the trigeminal nerve. ACTA ACUST UNITED AC 2006; 100:215-25. [PMID: 16037780 DOI: 10.1016/j.tripleo.2004.12.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the utility of magnetic resonance (MR) cisternography using 3-dimensional (3D) fast asymmetric spin-echo (FASE) sequences with multiplanar reconstruction (MPR) for detection of the sites of neurovascular compression (NVC) in patients with trigeminal neuralgia. STUDY DESIGN Both MR cisternography with 3D-FASE sequences and MR angiography (MRA) were performed on 150 patients with clinical signs and symptoms that suggested trigeminal neuralgia. Results from the original MR cisternography with 3D-FASE sequences, the original MRA, and 4 reformatted images were used for interpretation. Images with inversion between black and white were used from the MR cisternography with 3D-FASE sequences to evaluate NVC. A diagnosis of NVC was made from the presence of vascular contact with the trigeminal nerve at the root entry zone (REZ) and the nature of the involved vessels. For the patients with NVC detectable on 3D-FASE or MRA images, the relationship between the clinically manifested regions and the NVC sites was also evaluated. RESULTS Of the 150 patients evaluated, 89 were deemed to have NVC. Of these 89 patients, 3 underwent surgery that identified the artery that was involved with the trigeminal nerve. The correlation between the clinically manifested regions and the NVC sites was significantly detectable using both 3D-FASE images and MRA in 89 patients with detectable NVC. The correlation coefficient using 3D-FASE imaging was a little higher than that using MRA. Of the 61 patients deemed not to have NVC, 6 were found to have brain tumors that invaded the root entry zone of the trigeminal nerve. However, the remaining 55 patients had no identifiable cause for trigeminal neuralgia. NVC was found in the asymptomatic side in 27 (18%) of the 150 patients with trigeminal neuralgia using MR cisternography with 3D-FASE sequences. CONCLUSIONS The technique of MR cisternography using 3D-FASE sequences with MPR is more accurate and useful than MRA for detection of the site of NVC in patients with trigeminal neuralgia. Patients with trigeminal neuralgia should be further examined using MR imaging to rule out a brain tumor. Radiologists should understand that a few subjects with no symptoms could show NVC with MR cisternography.
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Affiliation(s)
- Tatsurou Tanaka
- Department of Dental Radiology, Kyushu Dental College, Kitakyushu, Japan
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Kito S, Morimoto Y, Tanaka T, Tominaga K, Habu M, Kurokawa H, Yamashita Y, Matsumoto S, Shinohara Y, Okabe S, Matsufuji Y, Takahashi T, Fukuda JI, Ohba T. Utility of diffusion-weighted images using fast asymmetric spin-echo sequences for detection of abscess formation in the head and neck region. ACTA ACUST UNITED AC 2005; 101:231-8. [PMID: 16448927 DOI: 10.1016/j.tripleo.2005.02.078] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2004] [Revised: 02/25/2005] [Accepted: 02/25/2005] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the utility of new diffusion-weighted magnetic resonance images (DWI) using fast asymmetric spin-echo (FASE) sequences for the detection of abscess formation in patients with phlegmon in the oral and maxillofacial regions. METHODS We compared diffusion-weighted images using FASE sequences with those using the gradient-echo type of echo-planar images (EPI) in 10 control volunteers and 10 patients with phlegmon in the oral and maxillofacial regions. RESULTS Many kinds of tissues in the oral and maxillofacial regions were relatively well visualized in all subjects on FASE-DWI, but not well on EPI-DWI. Apparent diffusion coefficients calculated from FASE sequences in abscess areas of patients with phlegmon were significantly lower than those in abscess-free areas; however, apparent diffusion coefficients calculated from EPI were not significantly different due to prominent distortion in small sample size study. CONCLUSIONS We could accurately recognize the presence of abscess formation within inflammatory tissue in 5 patients with phlegmon using FASE-DWI. As an additional magnetic resonance examination, FASE-DWI might be useful in the detection of abscess formation in the oral and maxillofacial regions.
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Affiliation(s)
- Shinji Kito
- Department of Oral Diagnostic Science, Kyushu Dental College, Kitakyushu, Japan
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Morimoto Y, Tanaka T, Kito S, Tominaga K, Yoshioka I, Yamashita Y, Shibuya T, Matsufuji Y, Kodama M, Takahashi T, Fukuda J, Ohba T. Utility of three dimension fast asymmetric spin-echo (3D-FASE) sequences in MR sialographic sequences: model and volunteer studies. Oral Dis 2005; 11:35-43. [PMID: 15641965 DOI: 10.1111/j.1601-0825.2004.01052.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the utility of 3D-FASE for the visualization of salivary gland ducts for use in MR sialographic sequences. METHODS We compared MR sialographic images and virtual endoscopic views from 3D-FASE with those from three kinds of sequences described by previous reports in a 3D parotid gland duct model and volunteer. The four sequences were two-dimension fast spin-echo (2D-FSE), three-dimension fast spin-echo (3D-FSE), two-dimension fast asymmetric spin-echo (2D-FASE), and three-dimension fast asymmetric spin-echo (3D-FASE). RESULTS In the 3D parotid gland duct model, image visibility on visual score was clearest with 3D-FSE, followed by 3D-FASE (P = 0.028). In the volunteers, the visualization of images improved in the following order: 3D-FASE > 3D-FSE > 2D-FSE > 2D-FASE. CONCLUSIONS The technique of 3D-FASE sequencing is more suitable and useful for MR sialography with an appropriate acquisition time.
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Affiliation(s)
- Y Morimoto
- Department of Dental Radiology, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Japan.
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