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Ms. Zhen (pseudonym) held the inspection form, still a little confused.
It turned out that ms. Zhen, 40 years old, was usually in good health, and recently she always felt dry mouth, thinking that it was the reason for the changeable weather and the Spring Festival diet, but it was difficult to alleviate the increase in water intake, so she came to the Dental Clinic of Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine.
Doctors initially judged to be Sjogren's syndrome and suggested that she go to the nuclear medicine department to make an appointment for a salivary gland function imaging test.
In the department of nuclear medicine, Ms. Zhen asked confusedly and vigilantly, what is the imaging of salivary gland function?
Dr. Huang Xiaojuan took out the schematic diagram and patiently explained to Ms. Zhen that the salivary glands refer to the glands that secrete saliva, which are mainly composed of three pairs of glands: the parotid glands, the submandibular glands and the sublingual glands.
Salivary gland secretion decreased, there will be dry mouth, swallow dry food (such as biscuits, steamed buns, etc.) need to drink frequent water to help and other symptoms, if there is no saliva or less saliva persists, it will also cause rampant caries, in a short period of time multiple teeth become black, defective, and even fall out.
Anatomical diagram of the salivary glands
Salivary gland function imaging is a kind of radionuclide imaging unique to the department of nuclear medicine, which is a common method for understanding the uptake, secretion, excretion function of salivary glands and the presence or absence of mass lesions.
By injecting the intravenous nuclear medicine imaging agent 99mTcO4-, it is uptaken and accumulated by the ductal epithelial cells in the lobular lobules of the salivary glands, and secreted under certain acid stimulation, and then excreted to the oral cavity, and the detection imaging is carried out by the nuclear medicine machine to understand the location, size, morphology and function of the salivary glands.
Hearing this, Ms. Zhen became excited: "Radionuclide?! Is there radiation in this test? Is it harmful to the human body? ”
The department of nuclear medicine often encounters such problems, in fact, it is not necessary to smell the discoloration of the "nuclear".
Physician Huang explained that due to the application of radionuclides, there will indeed be a certain amount of radiation, but all examinations are in line with national standards, and the amount of radiation is relatively safe for normal human beings.
Taking salivary gland function imaging as an example, the injection dose is small (185~370MBq (5~10mCi)), and the radionuclide half-life is also short (6.02h), so the radiation is low when the patient leaves the examination room, and a single examination will not pose a radiation hazard to the human body.
"One lie flat, two injections, three lozenges"
The process of imaging salivary gland function is also simple
"Lie flat"
Refers to removing metal objects, keeping the head still and lying quietly on the machine;
"Injection"
Imaging agent is injected by a nurse;
"Lozenges"
Vitamin C tablets (or vitamin C solutions) are taken sublingually after a period of injection of imaging agent to stimulate saliva secretion and help observe secretory excretion.
Ms. Zhen put her mind at ease, listened to the guidance, kept her head still and lay quietly, until she heard the voice prompts to check the end, you can leave with your belongings, the whole process lasted about 30 minutes, no pain, no itching, no discomfort.
The next day, the examination results showed that Ms. Zhen's bilateral salivary gland uptake and excretion function were significantly reduced.
Compared with the normal images, Ms. Zhen's images showed that the imaging of the bilateral parotid glands and submandibular glands was not clear, and the imaging agent uptake was significantly reduced, indicating that the uptake function was significantly reduced; when the acid stimulation, the bilateral salivary gland development was not significantly reduced, and the intraoral imaging agent was not increased, indicating that the excretion function was significantly reduced. From the curve point of view, the uptake curve of bilateral parotid glands and submandibular glands rises slowly, and there is no significant change in the technetium curve after acid stimulation.
With the imaging results of salivary gland function, Ms. Zhen can go to the Rheumatology and Immunology Clinic for further diagnosis and treatment.
Normal imaging of salivary glands
Imaging of Ms. Zhen's salivary glands
Salivary gland function imaging is a very mature and safe examination item in the Department of Nuclear Medicine, non-invasive, simple and accurate, and patients do not need to worry and nervous; no special preparations are required on the day of the examination, but attention is paid not to taking atropine or potassium perchlorate and other drugs that affect salivary gland function, and if the parotid X-ray is done recently, it is necessary to postpone the examination for several days.
In addition, the clinical application of salivary gland functional imaging is not limited to Sjogren's syndrome.
Indications for imaging of salivary gland function
1
Judgment of salivary gland function: diagnosis of Sjogren's syndrome, detection of residual glands after salivary gland surgery, judgment of salivary gland function of transplanted salivary glands;
2
Diagnosis of mass lesions: eg lymphoid papillary cystic adenoma (also known as adenoma, Warthin tumor);
3
Salivary stone syndrome;
4
Detection of ectopic salivary glands.
Source: Run Run Shaw Hospital
Author: Department of Nuclear Medicine, Huang Xiaojuan, Chen Liang
Original works, reprinted please indicate the source and source
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