The use of echocontrasty as a diagnostic method for pathologies of the ductal system of the salivary glands

Introduction. Visualizing a violation of the patency of the duct system of the salivary glands is a difficult task for a medical practitioner. Obstruction is possible due to various pathological conditions from calculus to stenosis. Ultrasound examination may be the primary stage in the algorithm for diagnosing salivary glands.
The objective was to implement the latest diagnostic method for the pathology of the ductal system of the parotid salivary glands using ultrasound examination (ultrasound) with intraductal echocontrast agent based on a clinical case.
Methods and materials. The patient L. came with complains of enlargement of the left parotid-chewing area when eating. She underwent a number of examinations, including ultrasound without contrast and without salivation stimulation at the outpatient stage. Cone beam computed tomography combined with sialography (CBCT-sialography), diagnostic sialoscopy, dynamic scintigraphy, as well as ultrasound with contrast of the ductal system.
Results. As a result of the conducted studies, the patient was diagnosed with pathology of the Stenon duct of the left parotid salivary gland. The patient is preparing for an elective surgery.
Conclusion. The authors describe the clinical case of using ultrasound contrast agent for non-tumor pathology of the salivary gland. This method has increased its informative value. Therefore, further research and experience accumulation are necessary.

1. Sencha A. N., Mogutov M. S., Penaeva E. I. et al. Ultrasonography with using contrast agents. Moscow, Vidar, 2015:5–117. (In Russ.).

2. Ascenti G., Mazziotti S., Zimbaro G. et al. Complex cystic renal masses: characterization with contrast-enhanced US // Radiology. 2007;243:158–165.

3. Balen F. G., Allen C. M., Lees W. R. Review ultrasound contrast agents // Clin. Radiol. 1994;49:77.

4. Chiorean L., Tana C., Braden B. et al. Advantages and Limitations of Focal Liver Lesion Assessment with Ultrasound Contrast Agents: Comments on the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines // Med Princ Pract. 2016;25(5):399–407.

5. Albrecht T., Thorelius L., Solbiati L. et al. Contrast-enhanced ultrasound in clinical practice. Springer-Verlag Italy, 2005:39–49.

6. Durot I., Wilson S. R., Willmann J. K. Contrast-enhanced ultrasound of malignant liver lesions // Abdom Radiol. 2018;43:819–847.

7. Forsberg F., Tao Shi W. Physics of contrast microbubbles // Ultrasound contrast agents: basic principles and clinical applications / Goldberg B., Raichlen J. S., Forsberg F. (eds). Dunitz, London, 2001, p. 15–23.

8. Kim A. Y., Lee M. W., Rhim H. et al. Pretreatment evaluation with contrast-enhanced ultrasonography for percutaneous radiofrequency ablation of hepatocellular carcinomas with poor conspicuity on conventional ultrasonography // Korean J Radiol. 2013;14(5):754–763.

9. Lyshchik A., Kono Y., Dietrich C. F. et al. Contrast-enhanced ultrasound of the liver: technical and lexicon recommendations from the ACR CEUS LI-RADS working group // Abdom Radiol (NY). 2018;43(4):861–879.

10. Squires J. H., Beluk N. H., Lee V. K. et al. Feasibility and Safety of Contrast-Enhanced Ultrasound of the Neonatal Brain: A Prospective Study Using MRI as the Reference Standard // AJR Am J Roentgenol. 2022;218(1):152–161. https://doi.org/10.2214/AJR.21.26274. PMID: 34286594.

11. Shpak O., Verweij M., de Jong N., Versluis M. Droplets, Bubbles and Ultrasound Interactions // Adv Exp Med Biol. 2016;880:157–74.

12. Tian Y., Liu Z., Tan H. et al. New Aspects of Ultrasound-Mediated Targeted Delivery and Therapy for Cancer // Int J Nanomedicine. 2020;15:401–418. https://doi.org/10.2147/IJN.S201208. PMID: 32021187; PMCID: PMC6982438.

13. Wilson S. R., Barr R. G. Contrast-enhanced ultrasound: the ideal contrast imaging study for pregnant patients // Abdom Radiol. 2023;48:3553.

14. Ward M., Wu J., Chiu J. F. Ultrasound-induced cell lysis and sonoporation enhanced by contrast agents // J Acoust Soc Am. 1999;105(5):2951–7. https://doi.org/10.1121/1.426908. PMID: 10335644.

15. Yang Z., Zhang M. B., Luo Y. K. Advances in Molecular Targeted Ultrasound Contrast Agents // Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2023;45(2):298–302. (Chinese). https://doi.org/10.3881/j.issn.1000-503X.14827. PMID: 37157079.

16. Yan J., Yin M., Foster F. S., Démoré C. E. M. Tumor Contrast Imaging with Gas Vesicles by Circumventing the Reticuloendothelial System // Ultrasound Med Biol. 2020;46(2):359–368. https://doi.org/10.1016/j.ultrasmedbio.2019.09.009. PMID: 31708270.