RU-2861637-C1 - METHOD FOR DETECTING PATHOLOGICAL CHANGES IN DUCTS OF PAROTID SALIVARY GLANDS

RU2861637C1RU 2861637 C1RU2861637 C1RU 2861637C1RU-2861637-C1

Abstract

FIELD: medicine; radiation diagnostics. SUBSTANCE: invention can be used in diagnosing diseases of the salivary glands. Physiological NaCl solution in a volume of 1-10 ml is introduced into the parotid salivary gland duct until the patient feels a feeling of fullness. MR sialography is performed in a three-dimensional mode with an isotropic voxel and a slice thickness of 1 mm. The main duct, ducts of the I, II and III order are visualised. In the presence of narrowing, dilation or a filling defect of the duct, a conclusion is made about the presence of pathological changes in the ducts of the parotid salivary glands. EFFECT: increasing the accuracy of diagnosis, optimising patient management tactics by selecting the most effective treatment method for a particular patient, reducing the time spent in a medical facility and the duration of the recovery period by ensuring visualisation of the entire ductal system. 1 cl, 4 dwg, 3 ex

Inventors

Fomchenko Anton Aleksandrovich
Vishnyakova Marina Valentinovna
STEPANOVA ELENA ALEKSANDROVNA
CHUKUMOV RINAT MARATOVICH
SIPKIN ALEKSANDR MIKHAJLOVICH
Geonya Ivan Vadimovich
Utiashvili Natela Iosifovna

Dates

Publication Date: 20260506
Application Date: 20250529

Claims (1)

A method for detecting pathological changes in the ducts of the parotid salivary glands, including visualization of the duct system using MR sialography, characterized in that a physiological solution of NaCl in a volume of 1-10 ml is introduced into the duct of the parotid salivary gland until a feeling of distension occurs in the patient, while MR sialography is carried out in a three-dimensional mode with an isotropic voxel and a slice thickness of 1 mm, the main duct, ducts of the first, second and third order are visualized, in the presence of narrowing, expansion or a filling defect of the duct, a conclusion is made about the presence of pathological changes in the ducts of the parotid salivary glands.

Description

The invention relates to medicine, to radiation diagnostics, namely to the diagnosis of diseases of the salivary glands. Salivary gland diseases represent a diverse set of pathologies, which can include inflammatory, neoplastic, autoimmune, and other processes. Advances in imaging technologies have made it possible to more thoroughly characterize the changes detected. Diagnostic methods for salivary gland function are also evolving, employing various methods of contrasting the gland's ductal system. A method for diagnosing the state of the ductal system is known using retrograde cone-beam computed tomography sialography (CBCT sialography), which involves installing a subclavian catheter under ultrasound control into the cavity of the duct expansion percutaneously (Razumova A.Ya., Zubareva A.A., Yaremenko A.I., Kutukova S.I., Petrov N.L. Retrograde CBCT sialography technique for obstructive syndrome of the parotid salivary gland. Scientific notes of the First Saint Petersburg State Medical University named after Academician I.P. Pavlov. 2024; 31 (3): 95-100. https://doi.org/10.24884/1607-4181-2024-31-3-95-100). Next, an iodine-containing X-ray contrast agent was administered, after which a cone-beam tomography of the maxillofacial region was performed. The disadvantage of this method is the use of an iodine-containing contrast agent (which can cause an allergic reaction), as well as radiation exposure during this study. A known method of sialography involves searching for the opening of the parotid or submandibular duct and its catheterization. (Shchipsky, A. V. Sialography. History and Prospects of the Method / A. V. Shchipsky, S. A. Kondrashin // Russian Electronic Journal of Radiation Diagnostics. - 2014. - Vol. 4, No. 2. - Pp. 28-38. - EDN SHQSYV.). Next, an iodine-containing contrast agent is introduced and digital X-ray sialography is performed. The disadvantage of this method is its lack of accuracy in obtaining an X-ray image, as well as the use of an iodine-containing contrast agent (which may cause an allergic reaction), as well as the radiation exposure during this study. The closest method is magnetic resonance sialography (B. A. Arutyunyan, M. V. Kozlova, A. Yu. Vasiliev Magnetic resonance sialography - an alternative method for studying diseases of the parotid salivary glands // Medical Bulletin of the North Caucasus. - 2019. - Vol. 14, No. 1-1. - Pp. 100-102.), which includes bougienage of the parotid salivary gland duct with its subsequent obturation using a disposable plastic probe. After this, salivation was stimulated for 15 minutes using a 2% solution of ascorbic acid. Next, scanning was performed in three projections (Ax, Cor and Sag) on a series of T1-, T2-weighted tomograms and T2 - with suppression of the signal from fat tissue and in FIESTA mode. The slice thickness was 1-5 mm. A disadvantage of this method is the need to obstruct the parotid salivary gland duct and then stimulate salivary flow with ascorbic acid. Furthermore, the filling of the gland's ductal system depends entirely on the functional state of the salivary gland and the amount of saliva secreted during preparation for the examination. The MR sialography scan in the prototype of this invention was performed without the use of an isotropic voxel, which complicates visualization of the II and III ducts when constructing reconstructions in various planes. The objective of the proposed invention is to eliminate the aforementioned shortcomings and improve the accuracy of diagnosis by providing visualization of the entire ductal system, including visualization of ducts of the second and third order. To address this problem, a method for identifying pathological changes in the parotid salivary gland ducts, including visualization of the ductal system using MR sialography, is proposed. It involves injecting 1-10 ml of saline NaCl into the parotid salivary gland duct until the patient experiences a feeling of fullness. MR sialography is performed in 3D mode with an isotropic voxel and a slice thickness of 1 mm. The main duct, first-, second-, and third-order ducts are visualized. The presence of narrowing, dilation, or filling defects in the ducts is used to determine the presence of pathological changes in the parotid salivary gland ducts. Due to the dense filling of the gland's duct system with a physiological solution, a dense filling of the ducts of the first, second and third order is created in patients with various diseases of the parotid salivary glands. The saline solution helps to densely and evenly fill the entire excretory duct system of the parotid salivary gland, and the use of an isotropic voxel allows for obtaining a thin-section image (1 mm), which will be characterized by the same quality when constructed in any plane, which is essential for assessing the middle and distal sections of the gland's duct system. This type of scanning, by densely filling the gland's ductal system with saline, allows for maximum v