title: Contrast-enhanced ultrasound for monitoring effects of extracorporeal shock wave sialolithotripsy in sialolithiasis.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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.
authors.affiliation: Department of Otorhinolaryngology, University of Munich, Munich, Germany. vanessa.siedek@med.uni-muenchen.de
authors.forename: Vanessa
authors.initials: V
authors.lastname: Siedek
authors.forename: Dirk-André
authors.initials: DA
authors.lastname: Clevert
authors.forename: Margarita
authors.initials: M
authors.lastname: Rytvina
authors.forename: Stephan
authors.initials: S
authors.lastname: Ihrler
authors.forename: Laura V
authors.initials: LV
authors.lastname: Klotz
authors.forename: Alexander
authors.initials: A
authors.lastname: Berghaus
authors.forename: Sebastian
authors.initials: S
authors.lastname: Strieth
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D019220:High-Energy Shock Waves / Q000627:therapeutic use; D006801:Humans; D007089:Image Enhancement; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D010743:Phospholipids; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D018570:Risk Assessment; D015494:Salivary Gland Calculi / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D012793:Sialadenitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D013459:Sulfur Hexafluoride; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D055815:Young Adult
chemical_list: D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride