Dazhong Net·Poster News reporter Xu Ling correspondent Xia Qing reported from Jinan
Ms. Chen, 69 years old this year, has been feeling dry mouth and eyes for the past year and feels like drinking No amount of water can relieve it, and it has been aggravating for a month, so I went to the Stomatology Department of Jinan Central Hospital for treatment. The dentist asked Ms. Chen’s past medical history in detail. Ms. Chen said that she had suffered from high blood pressure and diabetes for nearly 10 years. The stomatologist suggested that Ms. Chen went to the nuclear medicine department to make an appointment for a dynamic imaging examination of the salivary glands. On the 2nd day, Ms. Chen received dynamic imaging of salivary glands in the Department of Nuclear Medicine. The examination results showed that the uptake and excretion of the patient’s bilateral salivary glands were significantly reduced. It shows that the uptake function is significantly reduced; after acid stimulation, the bilateral salivary glands have not been significantly reduced, and the intraoral imaging agent has not increased. The doctor said that this means that the excretory function is significantly reduced. From the curve, the uptake curves of bilateral parotid glands and submandibular glands rose slowly, and the technetium curve did not change significantly after acid stimulation (see Figure 1).
According to the dynamic imaging results of salivary glands, combined with the clinical symptoms of Ms. Chen’s dry mouth, dry eyes, and difficulty in drinking water, it is in line with Sjögren’s syndrome, Director Li Lusheng She gave a detailed explanation to Ms. Chen and suggested that she go to the Department of Rheumatology and Immunology. Later, Ms. Chen was diagnosed with Sjögren’s syndrome in the Department of Rheumatology and Immunology. After comprehensive treatment such as regulating immunity and improving circulation, her condition improved.
Sjogren’s syndrome (SS) is a chronic inflammatory autoimmune disease that mainly affects exocrine glands such as lacrimal and salivary glands. Involves the lungs, kidneys, digestive system, blood system, nervous system, etc., causing multiple organ system involvement in the whole body. The salivary gland imaging examination has important value in the diagnosis of Sjögren’s syndrome.
The current salivary gland imaging methods mainly include the following methods, namely, parotid angiography, salivary gland ultrasound, salivary gland MR and salivary gland dynamic imaging. Dynamic radionuclide imaging of salivary glands is a non-invasive, objective and reproducible test of salivary gland function. It can understand the location, size, shape and function of salivary glands, including uptake function, secretion function and duct patency, so it has certain clinical applications. Not very understanding yet. Director Li Lusheng gave you a detailed answer.
1. What are salivary glands?
Salivary glands refer to the glands that secrete saliva, mainly composed of three pairs of glands: parotid gland, submandibular gland and sublingual gland (Figure 2). Patients and friends can see it at a glance.
2. What is the dynamic imaging of salivary glands in nuclear medicine?
Dynamic imaging of salivary glands is a unique functional imaging in nuclear medicine. The ductal epithelial cells in the salivary gland lobules have the function of ingesting and secreting 99mTcO4- (pertechnetate, a nuclear medicine imaging agent). After intravenous injection of pertechnetate, it reaches the salivary gland with the blood, is taken up and accumulated by it, and is in the blood. It is secreted under certain acid stimulation and then excreted into the oral cavity. Through nuclear medicine SPECT imaging, salivary gland images and time-radioactivity curves were obtained to understand salivary gland location, size, morphology and function (uptake function, secretion function and duct patency) (see Figure 3).
3.What are the indications for dynamic salivary gland imaging?
Dynamic salivary gland imaging It is a very mature and safe examination item in nuclear medicine, and its clinical application is not limited to Sjogren’s syndrome. The following are the indications for this examination:
(1) Judgment of salivary gland function: such as Sjogren’s syndrome Symptoms diagnosis, residual glands after salivary gland surgery or the function of transplanted salivary glands; Diagnosis of ectopic salivary glands, etc.;
(3) Diagnosis of ectopic salivary glands, etc.
4. What should be paid attention to in salivary gland dynamic imaging examination?
No special preparation is normally required on the day of the exam. Just be careful not to take drugs that affect salivary gland function such as atropine or potassium perchlorate within 2 weeks. In addition, if you have had parotid X-ray imaging in the past week, you need to delay the examination for a few days.
The whole inspection process takes about 30 minutes. You need to lie down on the machine quietly, and the nurse will inject the imaging agent for you. After 15 minutes, the nurse will give you 5ml of acetic acid or a tablet of vitamin C. If you have saliva, you can swallow it. You will need to continue lying down for about 10 minutes until the test is over.
5.Is salivary gland dynamic imaging harmful to the human body?
Like other nuclear medicine examinations, this examination also uses radioactivity The nuclide is injected into the body, so there will be a small amount of radiation, but please rest assured that all the inspections are strictly in accordance with the national standards, and the radiation dose is safe for normal humans. For dynamic salivary gland imaging, the injection dose is small (5~10mCi), and the half-life of the imaging agent is also short (6 hours), and a single examination will not pose any harm to the human body.