Objective: The aim of this study was to assess chronic inflammatory conditions of major salivary glands by ultrasound elastography. Methods: 21 patients with chronic inflammatory conditions of major salivary glands and 21 healthy adult volunteers were included in this study. All participants underwent B-mode sonography and ultrasound elastography. The diagnostic performance of strain ratio and shear wave velocity was evaluated by sensitivity and specificity at the optimum cutoff point and the area under the receiver operating characteristic curve. Results: Cases showed statistically significant higher median strain ratio of parotid and submandibular gland than control group (p-value = 0.001). Total cases showed statistically significant higher median scores than control group (p-value < 0.001). At cut-off value of (1.13); diagnostic accuracy, sensitivity and specificity were 97.6, 95.2 and 100% respectively with AUROC 0.954 and confidence interval: 0.840–0.995. Cases showed statistically significant higher median shear wave velocity of parotid gland than control group (p-value = 0.022), with no statistically significant difference in submandibular gland in the two groups (p-value = 0.216). Total cases showed statistically significant higher median scores than control group (p-value < 0.001). At cut-off value of (23.5), diagnostic accuracy was 78.6% with a sensitivity of 81% and specificity of 76.2% with 0.819 AUROC and onfidence interval :0.669–0.920. Conclusion: Our initial experience suggests that elastography may be potentially useful for diagnosis of chronic inflammatory conditions of the major salivary glands. This conclusion needs to be further validated large sample studies.
PurposeThe purpose of this study was to assess cone-beam computed (CBCT) sialography imaging in the detection of different changes associated with lesions of salivary glands.Materials and MethodsThis study consisted of 8 cases with signs and symptoms from salivary gland lesions. Conventional sialography using digital panoramic and lateral oblique radiographs and CBCT sialography were performed for each subject. The radiographs were evaluated by 3 radiologists independently of each other. The results were compared between conventional sialography and CBCT sialography in the evaluation of various lesions associated with the salivary glands.ResultsThere was an agreement between the radiologists in interpreting the lesions that affected salivary glands with both techniques. The detection of the presence of stones or filling defects, stenosis, ductal evagination, dilatation, and space occupying lesions was 83% for conventional sialography compared with CBCT sialography. CBCT sialography was superior to conventional sialography in revealing stones, stenosis, and strictures, especially in the second and third order branches.ConclusionIt would be advisable to perform CBCT sialography in cases of obstructive salivary gland diseases for better demonstration of the ductal system of the gland.
Purpose This study was conducted to evaluate the accuracy of cone-beam computed tomography (CBCT) in detecting the posterior superior alveolar (PSA) artery canal in a sample of the Egyptian population. Materials and Methods CBCT images of 600 maxillary sinuses of patients were examined for the presence or absence of the PSA artery along the lateral wall of the maxillary sinus, and for the diameter and type of the canal in relation to age and sex. The distances from the canal to the alveolar crest and sinus floor were also measured. Each canal was assessed to determine whether it was bifid. Results The PSA artery canal could be detected in 92.0% of the sinuses. The mean distance from the inferior border of the PSA artery canal to the sinus floor was 8.2±2.2 mm (range, 3.2–13.6 mm) in males and 7.3±2.1 mm (range, 3.0–13.1 mm) in females. The mean distance from the inferior border of the PSA artery canal to the alveolar crest was 18.2±2.7 mm (range, 11.0–23.9 mm) in males and 17.4±2.3 mm (range, 10.8–23.5 mm) in females. The mean diameter of the PSA artery canal was larger in male subjects. The PSA artery canal was bifid in 8.7% of cases. The most frequently observed location of the PSA artery canal was intraosseous (82.2%). Conclusion CBCT was confirmed to be a valuable tool for evaluation and localization of the PSA artery before maxillary sinus lift surgery to avoid intraoperative bleeding.
PurposeThe aim of this study was to evaluate the characteristic features of oral and maxillofacial swellings that could be seen on ultrasonographic examinations.Materials and MethodsFifty patients with oral and/or maxillofacial swellings were randomly selected, thorough case histories and clinical examinations were done, ultrasonographic examinations with Doppler imaging were performed, and the features of every group were studied. Finally, histopathological evaluations were performed to identify the final diagnosis, according to which patients were classified into 5 groups; group I: inflammatory/space infection and abscess swellings, group II: cystic swellings, group III: lymph node swellings, group IV: benign swellings, and group V: malignant neoplastic swellings.ResultsA significant association (P<0.05), with a contingency coefficient of 0.88, was found between the histopathological and ultrasonographic diagnoses, with ultrasonography having a diagnostic accuracy of 89% in diagnosing maxillofacial swellings. The diagnostic accuracy of ultrasonography was 100% for lymph node and malignant swellings, followed by 98% for inflammatory and cystic swellings and 92% for benign swellings. The sensitivity of the ultrasonographic diagnosis was 100% for cystic, lymph node, and malignant swellings, followed by 91% for inflammatory swellings and 86% for benign swellings.ConclusionUltrasonographic features with Doppler imaging greatly aid in obtaining accurate diagnoses of oral and maxillofacial swellings. Ultrasonography is a recommended imaging tool for differentiating maxillofacial swellings and classifying them accurately.
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