【論文摘要】Sialoscintigraphy in Patients With Obstructive Salivary Gland Disorders

Deng-Yu Han ； Yen-Chun Chen ； Ya-Ju Tsai ； Chi-Ching Chang ； Chin-Hui Su ； Shih-Han Hung ； Chung-Huei Hsu

《核子醫學暨分子影像雜誌》 32卷1期 (2019/03) Pp. 45-46

https://doi.org/10.6332/ANMMI.201903.OC2

摘要

Introduction: To establish clinically applicable reference values in sialoscintigraphic quantitative data from patients with obstructive salivary gland disorders. Methods: This is a retrospective study (September 2016-December 2017) of 158 subjects who received sialoscintigraphies. Ninety-three (58.8%) of these were patients with single glandular swelling, pain and/or tenderness and clinically diagnosed obstructive sialoadenitis. The data of their affected and unaffected glands were collected. Fifty-three patients who fulfilled the American-European criteria for diagnosing Sjögren syndrome were also enrolled for comparing. Patients were intravenously injected 259 MBq (7 mCi) Tc-99m-O4 in a supine position. Immediate sequential images were acquired at the rate of one frame per 30 s for up to 70 frames, using a large field-of-view gamma camera equipped with a low-energy, high-resolution, parallel-hole collimator. At the 20th-min post injection, 20 mL of lemon juice was orally administrated. On the summation imaging, six regions of interest (ROIs) with equal dimension were drawn over the four glands, left temporal skull, and hypopharynx, respectively. The time activity curve (TAC) of each ROI was generated. There were five parameters calculated from the curve for quantitative analysis: (1) uptake ration (UR), (2) maximal accumulation (MA), (3) maximal excretion (ME), (4) time to maximal activity (Tmax), (5) time to minimal activity (Tmin). Validation was calculated using unpaired t-test. Mann-Whitney U test was used for non-parametric comparisons. Receiver-operating characteristic curve (ROC) and area under the ROC curve (AUC) were analyses. Results: The values of ME of affected parotid and submandibular glands were significantly lower than those of the unaffected glands (p ＜ 0.0001). In addition, the values of UR and MA of affected submandibular gland were lower than those of the unaffected glands (p ＜ 0.0001 and ＜ 0.05, respectively). As for Sjögren syndrome, significantly lower values of UR (p ＜ 0.0001), ME (p ＜ 0.0001), MA (p ＜ 0.005), and prolonged Tmax and Tmin (p ＜ 0.005) were found on submandibular glands. Lower ME (p ＜ 0.005) and prolonged Tmin (p ＜ 0.0001) were observed on the parotid glands. Conclusions: The TAC and semiquantitative values of UR, MA, ME, Tmax, and Tmin obtained from sialoscintigraphy are valuable tool for diagnosing and evaluating functional status of obstructive and parenchymal disorders of salivary glands.