Diş Hekimliğinde Ultrasonografi ve Malign Dokularda Kullanımı

Abstract

Ultrasonografi (USG), yumuşak dokuları incelemede kullanılan faydalı bir radyolojik teşhis yöntemidir. USG’de görüntü oluşumunda yüksek frekanslı ses dalgaları kullanılır. Yüksek frekanslı ses dalgaları bir dönüştürücü tarafından vücuda iletilir ve doku ara yüzünden yansıyan ekolar algılanarak bir ekranda görüntülenir. USG’nin gerçek zamanlı görüntü oluşturması, sık tekrarlanabilir olması ve iyonizan radyasyon içermemesi gibi birçok avantajı vardır. Tüm bunların yanında bazı dezavantajları da vardır. Görüntülerin yorumlanması ilgili hekimin tecrübesine ve bilgi birikimine bağlıdır, hava içeren yapılarda kullanılamaz ve kemik içi dokularda kullanımı çok faydalı değildir. USG teknolojisinde ilerleyen zamanla birlikte birçok gelişme meydana gelmiştir ve renkli Doppler USG, ultrason elastografi gibi kan akımı konusunda bilgi veren ve doku elastisitesini gösteren farklı türleri ortaya çıkmıştır. Maksillofasiyal bölgede tükürük bezi hastalıkları, yumuşak doku kitleleri, lenfadenopatiler, temporomandibular eklem (TME) hastalıkları, dil kanserleri ve intraosseöz lezyonlar gibi birçok alanda kullanımı mevcuttur. Lenf nodu muayenesi yapılırken, metastatik lenf nodlarının tespitinde ve takibinde USG’den yararlanılır. İntraoral USG’nin, sonraki lenf nodu metastazlarının tespiti de dahil olmak üzere dil kanserlerinin uygun tedavi planlamasını belirlemek için tümör invazyonunun derinliğinin değerlendirilmesinde rutin bir teknik olarak kullanılmaya başlanması yararlı olacaktır. USG kullanımı yüzeyel tükürük bezi tümörlerinin teşhisinde de oldukça faydalıdır. Malign tükürük bezi tümörlerinin genellikle düzensiz sınırlı olması ve heterojen iç yapıda olması tükürük bezi tümör değerlendirmelerinde USG kullanımını ön plana çıkarır. Ayrıca USG ince iğne aspirasyon biyopsisinde rehber olarak kullanılmaktadır. Bu makalenin amacı servikal lenf nodu metastazları, dil kanserleri ve malign tükürük bezi tümörleri gibi maksillofasiyal bölge malignitelerinde USG’nin teşhis, tedavi planlaması ve takipteki kullanımı ve uygulamadaki etkinliği konusunda ilgili güncel literatürü değerlendirerek bilgi vermektir.

Keywords

• Dil kanseri
• maksillofasiyal bölge
• ultrasonografi
• servikal lenf nodu metastazı
• tükürük bezi tümörü

Ultrasonography in Dentistry and Its Use in Malignant Tissues

Abstract

Ultrasonography (USG) is a useful radiological diagnostic method used to examine soft tissues. High frequency sound waves are used in image formation. High frequency sound waves are transmitted to the body by a transducer and echoes reflected from the tissue interface are detected and displayed on a screen. USG has many advantages such as real-time image creation, frequent repeatability and not containing ionizing radiation. On the other hand there’re some disadvantages. The interpretation of the images depends on the experience and knowledge of the relevant specialist, they cannot be used in structures containing air and their use in intra-bony tissues isn’t useful. USG has evolved over time and different types such as color Doppler USG, ultrasound elastography have emerged that provide information about blood flow and show tissue elasticity. USG is used in many areas such as salivary gland diseases, soft tissue masses, lymphadenopathies, temporomandibular joint, tongue cancers and intraosseous lesions in the maxillofacial region. USG is used in the determination and follow-up of metastatic lymph nodes while performing lymph node examination. It would be beneficial to start using intraoral USG as a routine technique in evaluating the depth of tumor invasion to determine the appropriate treatment planning of tongue cancers, including the detection of subsequent lymph node metastases. USG is very useful in the diagnosis of superficial salivary gland tumors. Malign salivary gland tumors are usually irregularly demarcated and heterogeneous internal structure. This situation highlights the use of USG in salivary gland tumor evaluations. USG is used as a guide in fine needle aspiration biopsy. The purpose of this article is to provide information by evaluating the current literature about the use of USG in diagnosis, follow-up and treatment planning, and its effectiveness in practice in maxillofacial malignancies such as cervical lymph node metastases, tongue cancers and malignant salivary gland tumors.

Keywords

• Tongue cancer
• maxillofacial region
• ultrasonography
• salivary gland tumor
• cervical lymph node metastasis

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