Intraductally applied contrast-enhanced ultrasound (IA-CEUS) for improved visualization of obstructive diseases of the salivary glands, primary results

Abstract

Purpose: Obstructive diseases of the salivary glands are often based on Sialolithiasis; however, conventional radiological imaging or ultrasound does not provide a diagnosis in 5-10% of all cases. It was the aim of our study to examine the effectiveness and viability of an intraductal applied contrast-enhanced ultrasound (IA-CEUS) to improve the visualization of obstructive diseases of the salivary glands in comparison to conventional ultrasound and clinical symptoms.Materials and methods: The study included fifteen patients with swelling of indeterminate cause and/or pain of one or more salivary glands. A high-end ultrasound machine (Siemens, ACUSON, S 2000, Germany) with a multi-frequency linear 9 MHz transducer was used to carry out contrast-enhanced ultrasound with SonoVue ® .Results: All patients were examined using all diagnostic ultrasound tools of the study. The results show that the procedure is easy and convenient to perform, as well as efficient, but more significantly, that the intraductal contrast agent improved the diagnostic assessment capabilities of ultrasound for patients with obstructive salivary gland diseases, thereby helping to identify the best treatment.Conclusion: In comparison to conventional ultrasound, the use of an intraductal applied contract-enhanced ultrasound not only improved the visualization of the glandular duct system as a whole, but was less time-consuming as well as more reproducible. Thus, IA-CEUS with an intraductal applied contrast agent (IA-CEUS) is a promising tool that provides additional helpful information and an improvement for cases involving patients with unclear symptoms.

Intraoperative Visualization and Treatment of Salivary Gland Dysfunction in Sjögren’s Syndrome Patients Using Contrast-Enhanced Ultrasound Sialendoscopy (CEUSS)

“…Furthermore, the procedure was easily implemented and did not cause additional pain or inconvenience for the patients compared to classic sialendoscopy [ 42 ]. Moreover, our results correspond with a previous study using the same non-ionic contrast agent in salivary glands of patients without SS [ 43 ]. Furthermore, the CEUSS procedure is inexpensive, not time-consuming (mean: 33 min; range 21–50 min), and might be performed multiple times under local anesthesia [ 43 , 44 ].…”

The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version)

“…CEUS injected into the main duct of a salivary gland may be a diagnostic method to categorize obstructive diseases of the salivary glands. The salivary gland is cannulated with appropriate dilatators and the plastic tube of a peripheral vein catheter is inserted [531,532].…”

How to perform Contrast-Enhanced Ultrasound (CEUS)

“…The following clinical applications of EV-CEUS have been described in case studies: percutaneous nephrostomy 80 , biliary tract imaging via percutaneous transhepatic cholangiography and drainage (PTCD) 81 , abscess drainage 82 , swallow CEUS for imaging Zenker’s diverticulum, voiding vesicoureteral reflux sonography 83 84 , salivary gland duct imaging 85 , contrast-enhanced hysterosalpingo-sonography (CE-HyCoSy 86 , biliary tract imaging via endoscopic retrograde cholangiography (ERCP) 87 and fistula imaging 88 .…”