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Case No. 697
2024-09-01~2024-09-30
출제자 : 조세진
Hit : 511
| Period | 2024-09-01~2024-09-30 |
|---|---|
| Diagnosis | Juvenile recurrent parotitis ( or juvenile sjogren syndrome ) |
| Clinical information | 16세 여자 환자로 반복적인 턱 부음으로 내원함. 1) 가능한 영상 판독은? Images> T2WI, T1WI, Contrast T1WI, DWI |
| Discussion | 진단: Juvenile recurrent parotitis ( or juvenile sjogren syndrome ) Review RP is the most common inflammatory salivary gland disease in childhood and adolescence, with many assumed and possibly interwoven causes: genetic, immune, infection, dehydration, allergy, ductal abnormalities and ductal obstruction. JRP begins in early childhood and resolves in adolescence. It may be unilateral or bilateral. Patients present repeated episodes of painful swelling of the gland, sometimes complicated by a bacterial infection. Between two episodes, the volume of the gland returns to normal or, at least, decreases. At the end of the disease course, the parotid gland may be hard and mimic a tumor on clinical examination. Imaging findings: Ultrasonography may be sufficient for diagnosis, showing multiple hypoechoic foci of salivary secretions, scattered in the gland and inconstantly containing central calcification (Fig. 8a, b). Vascularization of the gland is a normal appearance, on Doppler color imaging [26]. According to the stage of the disease, early or late, the parotid gland is either enlarged or atrophic [23]. When a second imaging modality is needed, MR sialography can confirm the diagnosis. MRI reveals a non-dilated Stensen’s duct and multiple small “cystic” round areas of high signal on T2-weighted images (mimicking a bunch of grapes), in an enlarged gland (Fig. 8c, d) [27]. Treatment is not consensual: antibiotics, analgesics, sialendoscopy with unclogging |
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