儿童乳糜泻患者腮腺微血管增多但硬度无差异
这项前瞻性病例对照研究纳入78例活检确诊的儿童乳糜泻患者和72例年龄及BMI匹配的健康对照，采用微血管成像和剪切波弹性成像评估腮腺。结果显示乳糜泻组双侧腮腺微血管指数均高于对照组，但剪切波弹性成像测得的硬度无显著组间差异，且影像指标与tTG-IgA水平或Marsh分级无关。
要点
- 儿童乳糜泻患者腮腺微血管指数升高，提示亚临床微血管改变。
- 剪切波弹性成像测得的腮腺硬度在乳糜泻组与对照组间无显著差异。
- 腮腺影像指标与tTG-IgA水平或Marsh分级无显著关联。
关键影像表现/征象
- 乳糜泻组左侧腮腺微血管指数中位数为5.29（IQR 3.12-10.80），高于对照组的2.00（IQR 1.03-4.78），P<0.001。
- 乳糜泻组右侧腮腺微血管指数中位数为4.55（IQR 2.42-10.82），高于对照组的3.25（IQR 0.90-5.48），P=0.001。
- 剪切波弹性成像测得的腮腺硬度在两组间无显著差异（左侧P=0.21；右侧P=0.09）。
临床应用与阅片要点
- 在儿童乳糜泻患者中，腮腺超声可关注微血管指数升高这一亚临床征象。
- 剪切波弹性成像测得的腮腺硬度在此人群中未见显著改变，不宜单独作为筛查依据。
局限性
- 横断面设计无法明确微血管改变的时间动态及因果关联。
- 探索性研究结果需纵向验证以明确临床相关性。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
BACKGROUND: Celiac disease is a systemic autoimmune disorder that can affect salivary glands, yet subclinical involvement in children is under-investigated. Conventional ultrasound often lacks sensitivity for detecting early inflammatory or subtle microvascular changes in asymptomatic patients.
OBJECTIVE: We aimed to evaluate subclinical parotid gland involvement in children with celiac disease using microvascular imaging and shear wave elastography (SWE), hypothesizing that these tools could detect early parenchymal and microcirculatory alterations.
MATERIALS AND METHODS: This prospective, cross-sectional case-control study included 78 children with biopsy-confirmed celiac disease and 72 age- and body mass index-matched healthy controls. Bilateral parotid microvascularity index (MVI, %) and tissue stiffness (SWE, kPa) were assessed using high-resolution ultrasonography by an experienced radiologist who was blinded to the group allocation and clinical data. Between-group comparisons were performed using two-sided Mann-Whitney U tests. Within the celiac disease group, imaging metrics were explored according to gluten-free diet duration, serum tissue transglutaminase IgA (tTG-IgA) levels, and modified Marsh grade.
RESULTS: The MVI was higher in the celiac disease group for both the left (median [interquartile range], 5.29 [3.12-10.80] vs 2.00 [1.03-4.78]; P<0.001) and right (4.55 [2.42-10.82] vs 3.25 [0.90-5.48]; P=0.001) parotid glands. However, SWE did not differ significantly between groups (left P=0.21; right P=0.09). Within the celiac disease group, imaging metrics were not significantly associated with tTG-IgA levels or Marsh subtypes (all P>0.05).
CONCLUSION: Pediatric celiac disease is associated with increased parotid microvascularity without detectable stiffness differences, suggesting subclinical microvascular alterations. These exploratory findings warrant longitudinal validation to clarify temporal dynamics and clinical relevance.
引用
- Ergen YM, Teke S, Çaviş T, et al. Increased parotid microvascularity without stiffness differences in children with celiac disease. Pediatr Radiol. 2026. PMID: 42183855. doi:10.1007/s00247-026-06641-y
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。