Sonoelastography--a useful adjunct for parotid gland ultrasound assessment in patients suffering from chronic inflammation.
BACKGROUND
Shear wave elastography (SWE) is widely used in breast, liver, prostate and thyroid evaluations. Elastography provides additional information if used to assess parotid gland pathology. We assessed parotid glands by means of SWE to compare the parenchyma properties in different types of inflammation.


METHODS
Prospective analysis included 78 consecutive patients with parotid gland pathology: sialolithiasis (33), Stensen's duct stenosis (15), chronic inflammation (10), and primary Sjögren syndrome (pSS) (20) treated at the Department of Otolaryngology, Head and Neck Surgery of PUMS. The primary predictor variable was type of parotid pathology, and secondary predictor variables were patient age and the duration and intensity of complaints. Ultrasound pictures were compared with elastography values of parotid parenchyma.


RESULTS
Mean elasticity values for pSS (111 Kilopascals (kPa), Stensen's duct stenosis (63 kPa), sialolithiasis (82 kPa), and chronic inflammation (77 kPa) were significantly higher than the mean value for healthy patients (24 kPa). Elasticity increased proportionally to the intensity of complaints: mild (51 kPa), moderate (78 kPa), and strong (90 kPa). Increased elasticity did not correspond with ultrasonographic pictures. In pSS the parenchyma was almost twice as stiff as in chronic inflammation (p=0.02), although subjective complaints were mostly mild or moderate, and the ultrasonographic picture did not present features of fibrosis.


CONCLUSIONS
Sonoelastography, by improving routine ultrasonographic assessment, might be a useful tool for parotid evaluations during the course of chronic inflammation. An extraordinarily high degree of stiffness was revealed in pSS despite lack of fibrosis by ultrasonography and moderate subjective complaints, suggesting that sonoelastography could be a valuable diagnostic tool.
Department of Otolaryngology, Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland.
Małgorzata
M
Wierzbicka
Department of Otolaryngology, Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland.
Jarosław
J
Kałużny
Department of Endocrinology, Metabolism and Internal Medicine, Poznań University of Medical Sciences, Poznań, Poland.
Marek
M
Ruchała
2nd Department of General Radiology, Poznań University of Medical Sciences, Poznań, Poland.
Marek
M
Stajgis
Department of Otolaryngology, Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland.
Tomasz
T
Kopeć
Department of Endocrinology, Metabolism and Internal Medicine, Poznań University of Medical Sciences, Poznań, Poland.
Witold
W
Szyfter
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D054459:Elasticity Imaging Techniques / Q000379:methods*; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010306:Parotid Gland / Q000000981:diagnostic imaging*; D014465:Ultrasonics