Three Signs to Help Detect Sjögren's Syndrome: Incidental Findings on Magnetic Resonance Imaging and Computed Tomography.

This study aimed to retrospectively investigate the prevalence of Sjögren's syndrome (SS) among patients with ranulas, parotid cysts, or parotid calcifications; identify the characteristic magnetic resonance imaging (MRI) or computed tomography (CT) findings of the lesions associated with SS; and compare the SS disease stages among SS patients with the three lesion types. A total of 228 patients with the lesions were classified into SS, possible SS, and non-SS groups. The prevalence of SS among patients with ranulas, parotid cysts, or parotid calcifications was 16%, 24%, and 40%, and the rates of either SS or possible SS were 25%, 41%, and 64%, respectively.

Comparison of salivary gland MRI and ultrasonography findings among patients with Sjögren's syndrome over a wide age range.

Objectives: This retrospective study compared MRI and US findings among patients with SS over a wide age range.

Methods: Ninety patients with SS aged 8-84 years who had undergone both MRI and US examinations were divided into four groups according to age, as follows: <18 years (juvenile SS, JSS), 9 patients; 18-39 years, 12 patients; 40-69 years, 53 patients; >69 years, 16 patients. Imaging findings of parotid glands (PGs) and submandibular glands (SMGs) were compared among the four groups.

A case of periosteal fasciitis located in the mandible in a child.

Periosteal fasciitis (PF), a subtype of nodular fasciitis, is an uncommon benign soft-tissue mass that originates from the periosteum or tissues adjacent to bones. PF has rarely seen in children, especially involving in the mandible. This case report presents a rare case of PF originating from the periosteum of the mandible in an 11-year-old girl.

Juvenile primary Sjögren's syndrome with ranula: is ranula a clinical sign that leads to early detection of Sjögren's syndrome?

Juvenile primary Sjögren's syndrome (pSS) is rare. Although recurrent parotitis is reported to be the most common symptom of juvenile pSS, the clinical symptoms and features of the syndrome are not well understood and are poorly defined. Here we report a rare case of juvenile pSS in a patient with plunging ranula.

A case of tophaceous pseudogout of the temporomandibular joint extending into the cranium.

A case of tophaceous pseudogout (i.e., calcium pyrophosphate dihydrate crystal deposition disease) in the temporomandibular joint (TMJ) extending into the cranium is reported.

Magnetic resonance perfusion and diffusion characteristics of granulomatous diseases mimic those of malignant lesions: six case reports.

The perfusion and diffusion properties of a tumor are important clues in evaluating its growth potential and predicting its histological type, such as benign or malignant. Tumor perfusion can be estimated by assessing time-dependent changes in the intratumoral levels of the contrast agent during dynamic contrast-enhanced magnetic resonance (MR) imaging, whereas tumor diffusion can be estimated by assessing intratumoral water diffusivity on diffusion-weighted MR imaging. Granulomatous diseases with different etiologies occur in various head and neck regions, including the mandible, maxillary sinus, salivary glands, and lymph nodes.

Combined classification system based on ACR/EULAR and ultrasonographic scores for improving the diagnosis of Sjögren's syndrome.

We retrospectively evaluated the effectiveness of combined use of salivary gland ultrasonography (US) and the 2016 American College of Rheumatology/European League Against Rheumatic Disease (ACR/EULAR) classification criteria for improving the diagnostic efficiency in patients with Sjögren's syndrome (SS). A US-based salivary gland disease grading system was developed using a cohort comprising 213 SS or non-SS patients who fulfilled the minimum requirements for classifying SS based on the American-European Consensus Group (AECG) and ACR criteria. Using 62 SS or non-SS patients from the 213 patients and who had also undergone all the 5 examinations needed for the ACR/EULAR classification, we compared the diagnostic accuracy of various combinations of the ACR/EULAR and US classifications for diagnosing SS, using the clinical diagnosis of SS by rheumatologists as the gold standard.

Perfusion MR imaging detection of carcinoma arising from preexisting salivary gland pleomorphic adenoma by computer-assisted analysis of time-signal intensity maps.

Tumor perfusion can be evaluated by analyzing the time-signal intensity curve (TIC) after dynamic contrast-enhanced (DCE) MR imaging. Accordingly, TIC profiles are characteristic of some benign and malignant salivary gland tumors. A carcinoma ex pleomorphic adenoma (CXPA) arises from a long-standing pleomorphic adenoma (PA) and has a distinctive prognostic risk depending on the tumor growth potential such as invasion beyond the preexisting capsule.

Length of intact plasma membrane determines the diffusion properties of cellular water.

Molecular diffusion in a boundary-free medium depends only on the molecular size, the temperature, and medium viscosity. However, the critical determinant of the molecular diffusion property in inhomogeneous biological tissues has not been identified. Here, using an in vitro system and a high-resolution MR imaging technique, we show that the length of the intact plasma membrane is a major determinant of water diffusion in a controlled cellular environment and that the cell perimeter length (CPL) is sufficient to estimate the apparent diffusion coefficient (ADC) of water in any cellular environment in our experimental system (ADC = -0.

Simple and reliable determination of intravoxel incoherent motion parameters for the differential diagnosis of head and neck tumors.

Intravoxel incoherent motion (IVIM) imaging can characterize diffusion and perfusion of normal and diseased tissues, and IVIM parameters are authentically determined by using cumbersome least-squares method. We evaluated a simple technique for the determination of IVIM parameters using geometric analysis of the multiexponential signal decay curve as an alternative to the least-squares method for the diagnosis of head and neck tumors. Pure diffusion coefficients (D), microvascular volume fraction (f), perfusion-related incoherent microcirculation (D*), and perfusion parameter that is heavily weighted towards extravascular space (P) were determined geometrically (Geo D, Geo f, and Geo P) or by least-squares method (Fit D, Fit f, and Fit D*) in normal structures and 105 head and neck tumors.

Comparison between ultrasonography and MR imaging for discriminating squamous cell carcinoma nodes with extranodal spread in the neck.

Objective: To compare the diagnostic ability of ultrasonography (US) and MR imaging for discriminating squamous cell carcinoma (SCC) nodes with extranodal spread (ENS) in the neck.

Methods: US and MR imaging was retrospectively evaluated for differentiating ENS-positive (n=28) from ENS-negative (n=26) SCC nodes (>10mm short-axis diameter) in 50 patients with head and neck SCCs. We assessed nodal size on US and MR images; irregular nodal margin on US; and vanishing nodal border, flare, and shaggy nodal margin signs on T1-, fat-suppressed T2-, and contrast-enhanced T1-weighted MR images, respectively.

Multiparametric magnetic resonance imaging for the differentiation between benign and malignant salivary gland tumors.

Purpose: To evaluate the stepwise approach in differentiating between benign and malignant salivary gland tumors using time-intensity curves (TICs) and apparent diffusion coefficients (ADCs).

Materials And Methods: TICs and ADCs were analyzed on the tumor-by-tumor (overall) and pixel-by-pixel (TIC and ADC maps) bases in patients with benign (n = 52) or malignant (n = 18) salivary gland tumor. TICs were categorized into Types 1 (<20% increment ratio), 2 (>or=20% increment ratio and >120 sec peak time), 3 (>or=20% increment ratio, or=20% increment ratio, or=30% washout ratio).

MR factor analysis: improved technology for the assessment of 2D dynamic structures of benign and malignant salivary gland tumors.

Purpose: To establish an MR factor analysis technique for two-dimensional (2D) MR dynamic structures of benign and malignant salivary gland tumors.

Materials And Methods: Dynamic contrast-enhanced MRI using a surface coil was performed on 36 patients with benign (N = 24) or malignant (N = 12) salivary gland tumors. Signal intensity kinetics in each pixel of the tumors after contrast medium injections were semiautomatically categorized into four patterns (slow uptake, rapid uptake with high washout, rapid uptake with low washout, and flat).

Parotid tumors: differentiation of benign and malignant tumors with quantitative sonographic analyses.

We asked in this study if the quantitative sonographic analysis could diagnose effectively the benign and malignant tumors of the parotid gland. Sonographic analyses using mean grey values and SDs of echo levels were performed on the 21 benign tumors and 22 malignant tumors of the parotid glands. Both the mean grey level and the SD of the echo levels were significantly and characteristically different among the different parotid tumor groups.

Combination of helical CT and Doppler sonography in the follow-up of patients with clinical N0 stage neck disease and oral cancer.

Background And Purpose: Correctly diagnosing metastatic nodes is important for the follow-up of patients with clinical N0 stage neck disease and oral cancer. A combination of helical CT and Doppler sonography may facilitate the accurate detection of lymph node metastasis in patients with clinical N0 stage neck disease.

Methods: A combination of contrast-enhanced helical CT and Doppler sonography was performed to monitor the necks of 58 patients with initial clinical N0 stage neck disease.