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Contrast‐enhanced ultrasound for monitoring effects of extracorporeal shock wave sialolithotripsy in sialolithiasis
Author(s) -
Siedek Vanessa,
Clevert DirkAndré,
Rytvina Margarita,
Ihrler Stephan,
Klotz Laura V.,
Berghaus Alexander,
Strieth Sebastian
Publication year - 2012
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.23281
Subject(s) - medicine , sialadenitis , extracorporeal , submandibular gland , perfusion , ultrasound , contrast enhanced ultrasound , radiology , surgery , salivary gland , pathology
Objectives/Hypothesis: Contrast‐enhanced ultrasound (CE‐US) can be used for noninvasive analysis of functional vascularization. Chronically recurrent sialadenitis due to sialolithiasis of the submandibular gland is associated with increased vascularity. The aim of this investigator‐initiated clinical trial was the evaluation of CE‐US as a quantitative monitoring technique during gland‐preserving extracorporeal shock wave sialolithotripsy (ESWL). Study Design: In this prospective clinical evidence level 2c study, perfusion in patients (n = 10) with unilateral sialolithiasis of the submandibular gland was quantitatively analyzed using CE‐US before and after ESWL, comparing with the respective contralateral gland. Methods: Before CE‐US measurements, a subjective clinical score of complaints (range, 1–10) was documented. The contrast agent SonoVue was injected into a cubital vein. The intensity–time curve gradients (ITGs) were calculated from CE‐US data. Results: The ITGs derived from CE‐US measurements revealed higher perfusion in the affected submandibular gland compared to the contralateral side. In parallel to clinical complaints, parametric CE‐US data were significantly reduced after ESWL in chronic sialolithiasis‐associated sialadenitis. Conclusions: CE‐US–derived ITGs appear to be an independent and quantitative marker for treatment effects of ESWL. Clinical experience and further studies will have to validate this method as a diagnostic tool to decide especially whether to proceed to sialoadenectomy in therapy‐refractory cases.