超声在IgG4相关性颌下腺炎早期诊断中的作用  

The role of ultrasound in the early diagnosis of IgG4-associated submaxillaritis

作　　者：张雪[1,2] 谢海琴 陈芸[1,2] Zhang Xue;Xie Haiqin;Chen Yun(Peking University Shenzhen Hospital,Clinical College of Anhui Medical University,Shenzhen,Guangdong 518036,China;Department of Ultrasound Imaging,Peking University Shenzhen Hospital,Shenzhen,Guangdong 518036,China)

机构地区：[1]安徽医科大学北京大学深圳医院临床学院,广东深圳518036 [2]北京大学深圳医院超声影像科,广东深圳518036

出　　处：《影像研究与医学应用》2021年第11期10-11,14,共3页Journal of Imaging Research and Medical Applications

摘　　要：目的:结合临床症状和血清检查,探讨超声在IgG4相关性颌下腺炎(IgG4-related submaxillaritis,IgG4-RS)早期诊断中的作用。方法:回顾性分析2014年1月—2020年12月在我院收治的10例(15处病灶)经病理确诊的IgG4-RS患者的超声表现和临床及病理资料。结果:临床表现为颌下无痛性肿物,质地较硬,双侧受累患者均累及其他部位。血清检测IgG4浓度升高。超声表现分为局限型和弥漫型两种,其中9处病灶为局灶性病变,可见腺体内单发或多发低回声团块;6处病灶为弥漫性病变,腺体弥漫性回声偏低,分布不均匀,部分呈网格状改变。病理免疫组化结果:IgG4阳性(>100个/HPF),IgG4/IgG>40%。结论:临床症状和超声表现对IgG4-RS的早期诊断具有一定提示作用,患者出现无痛性颌下肿物,不伴口干、眼干等症状,超声显示腺体浅方低回声团块或弥漫性回声改变,应考虑I g G4-R S可能,临床结合血清IgG4水平,尽早在超声引导下行穿刺病理检查,以辅助临床早期诊断,减少非必要的手术。Objective To explore the role of ultrasound in the early diagnosis of IgG4-associated submaxillaritis(IgG4-RS)by combining clinical symptoms and serum examination.Methods The ultrasonographic manifestations,clinical and pathological data of 10 patients(15 lesions)who were diagnosed by pathology in our hospital from January 2014 to December 2020 were retrospectively analyzed.Results The clinical manifestations were painless submaxillary mass with hard texture,and other parts were involved in both patients.The serum IgG4 concentration was elevated.Ultrasonographic findings were divided into two types:localized and diffuse.Nine lesions were focal lesions with single or multiple hypoechoic masses in the glands.Six lesions were diffuse lesions,and the diffuse echo of the glands was low and uneven,and some of them showed grid changes.Pathological immunohistochemical results:IgG4 positive(>100/HPF),IgG4/IgG>40%.Conclusion Clinical symptoms and sonographic findings of IgG4-RS can prompt early diagnosis,patients with painless jaws neoplasm,with symptoms such as dry mouth,dry eye,the possibility of IgG4-RS should be considered when ultrasound showed glandular shallow low echo mass or diffuse echo change,in combination with clinical IgG4 serum levels,in downward biopsy guided by ultrasound examination as soon as possible,to assist clinical early diagnosis,reduce unnecessary surgery.

关 键 词：IgG4相关性颌下腺炎 临床诊断 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]