Sialolithiasis is the main cause of unilateral diffuse parotid or submandibular gland swell― ing. Its incidence has been poorly studied but seems to be much higher than the classic a data published by Rauch of 1 case per 300 000 people per year. 1 In a recent study, based on hospital admission figures in England, Escudier and McGurk 2 estimated this incidence to be between 1 per 15000 and 1 per 30000. Personal observations of an incidence between 1 per 10000 and 1 per 20000 seem to confirm these results (F.M. and P.D., unpublished data, 2002). Sialolithiasis results in a mechanical obstruction of the salivary duct, causing repetitive swelling during meals, which can remain transitory or be complicated by bacterial infections. 3,4 Traditionally, recurring episodes necessitate treatment by open surgery, and sialolithiasis still represents the most frequent reason for submandibular gland resection. 5,6 Interestingly, parotid gland resection remains less frequent, probably because of the higher incidence of postoperative complications such as facial paresis.

/pdf/sialolithiasis-management-the-state-of-the-art-3slq53b4qy.pdf

Sialolithiasis management: the state of the art.

Ultrasonography (US) is useful for differential diagnosis of diseases of the salivary glands. In acute inflammation, salivary glands are enlarged and hypoechoic with increased blood flow; they may contain multiple small, oval, hypoechoic areas. In chronic inflammation, salivary glands are normal sized or smaller, hypoechoic, and inhomogeneous. Sialolithiasis appears as markedly hyperechoic lines or points with distal acoustic shadowing. Sialosis appears as enlarged hyperechoic glands without focal lesions or increased blood flow. The US features of advanced Sjogren syndrome include inhomogeneous salivary glands with scattered small, oval, hypoechoic or anechoic areas, usually well defined, and increased parenchymal blood flow. Pleomorphic adenomas are usually hypoechoic, well-defined, lobulated lesions with posterior acoustic enhancement that may contain calcifications; Warthin tumors are usually oval, hypoechoic, well-defined lesions that often contain anechoic areas and are often hypervascularized. Malignant neoplasms of the salivary glands may have irregular shapes, irregular borders, blurred margins, and a hypoechoic inhomogeneous structure or may have a benign appearance. Salivary gland cysts have well-defined margins, anechoic contents, posterior acoustic enhancement, and no internal blood flow. However, US appearances of some diseases may overlap, thus producing diagnostic pitfalls.

US of the Major Salivary Glands: Anatomy and Spatial Relationships, Pathologic Conditions, and Pitfalls

This invention is a catheter-based device for generating an ultrasound excitation in biological tissue. Pulsed laser light is guided through an optical fiber (10) to provide the energy for producing the acoustic vibrations. The optical energy is deposited in a water-based absorbing fluid, e.g. saline, thrombolytic agent, blood or thrombus, and generates an acoustic impulse in the fluid through thermoelastic and/or thermodynamic mechanisms. By pulsing the laser at a repetition rate (which may vary from 10 Hz to 100 kHz) an ultrasonic radiation field can be established locally in the medium. This method of producing ultrasonic vibrations can be used in vivo for the treatment of stroke-related conditions in humans, particularly for dissolving thrombus or treating vaspasm. The catheter (14) can also incorporate thrombolytic drug treatments as an adjunct therapy and it can be operated in conjunction with ultrasonic detection equipment for imaging and feedback control and with optical sensors for characterization of thrombus type and consistency.

Opto-acoustic thrombolysis

The authors assess the value of magnetic resonance (MR) image texture in Alzheimer's disease (AD) both as a diagnostic marker and as a measure of progression. T/sub 1/-weighted MR scans were acquired from 40 normal controls and 24 AD patients. These were split into a training set (20 controls, 40 AD) and a test set (20 controls, 14 AD). In addition, five control subjects and five AD patients were scanned repeatedly over several years. On each scan a texture feature vector was evaluated over the brain; this consisted of 260 measures derived from the spatial gray-level dependence method. A stepwise discriminant analysis was applied to the training set, to obtain a linear discriminant function. In the test set, this function yielded significantly different values for the control and AD groups (p 0.05); for the repeatedly scanned AD patients the corresponding median increment of 1.4 was significantly different from zero (p<0.05). MR image texture may be a useful aid in the diagnosis and tracking of Alzheimer's disease.

MR image texture analysis applied to the diagnosis and tracking of Alzheimer's disease

PURPOSE: To determine the value of magnetic resonance (MR) sialography for the diagnosis of sialolithiasis by comparing results prospectively with those of ultrasonography (US) and digital sialography. MATERIALS AND METHODS: MR sialography was prospectively performed with T2-weighted three-dimensional (3D) constructive interference in steady-state (CISS) and rapid acquisition with relaxation-enhancement (RARE) sequences in 24 patients suspected of having sialolithiasis. Evoked salivation was used as contrast material. T1-weighted spin-echo and T2-weighted turbo spin-echo MR imaging also were performed. The results were then compared with those of US and digital sialography, with the latter as standard of reference. RESULTS: The 3D CISS images were significantly (P < .05) superior to RARE images for demonstrating the submandibular ductal system, followed by T2-weighted turbo spin-echo images (P < .01) and T1-weighted spin-echo images (P < .001). The sensitivity and specificity were 100% and 80%, respective...

Sialolithiasis: MR sialography of the submandibular duct--an alternative to conventional sialography and US?

Non-absorbable fat-dense oral contrast agent for abdominal computed tomography.

In this paper a new approach for quantitative description and recognition of brain tumours in three-dimensional MR image sequences is presented. In radiological diagnostics, tumour features like shape, irregularity of tumour borders, contrast-enhancement etc. are used in a qualitative way. The presented image analysis methods extract quantitative descriptions of two- and three-dimensional tumour features. The tumour shape is described by ellipsoid approximations and the analysis of tumour profiles. Fractal features quantify irregularities and self-similarities of tumour contours. The internal tumour structure and especially the homogeneity of tumour tissue is analysed by means of texture analysis. The extracted features reflect 3D information about tumour morphology. The high-dimensional feature information is analyzed by the nearest neighbour classifier. Furthermore, in combination with the leaving-one-out method the nearest neighbour classifier is used to select proper feature subsets discriminating different tumours types. In a clinical study, the developed methods were applied to image sequences with the four most frequent brain tumours: meningiomas, astrocytomas, glioblastomas, and metastases. The clinical accuracy of radiologists in identifying brain tumours is approx. 80% [KWG+89], The automatic recognition of tumour types achieves a classification rate of 93%.

Characterisation and Classification of Brain Tumours in Three-Dimensional MR Image Sequences

Neural network approach for computer-assisted interpretation of ultrasound images of the gallbladder

Initial clinical experience with a new pulsed dye laser device in angioplasty of limb ischemia and shunt fistula obstructions.

Fourteen examinations of the tear ducts and 21 sialograms were performed using digital subtraction and conventional techniques. In nine of the former and 15 of the latter, digital subtraction produced better results, in the remainder conventional technique was equally good. The advantages of digital subtraction are due to the removal of superimposed structures of the skull. Dose measurements at the level of the lens of the eye showed a greatly reduced radiation dose when using digital subtraction, as compared with conventional dacryocystography. Digital subtraction techniques with pulsed radiation and the ability to perform pixel shift is an optimal method for performing radiological examinations of the tear ducts and salivary glands.

Dakryozystographie und Sialographie in digitaler Subtraktion

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