Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of parotid gland function in type 2 diabetes patients using diffusion-weighted imaging before and after acid stimulation

  • Original Article
  • Published:
International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Purpose

To investigate the performance of diffusion-weighted magnetic resonance imaging (DW-MRI) as a noninvasive tool for assessing parotid gland function in type 2 diabetes mellitus (T2DM) patients.

Methods

T2DM patients (n = 40, male, age 40–60 years) and healthy controls (n = 40) were examined. Salivary function was assessed using 1.5D echo-planar diffusion-weighted imaging. The examinations were performed before and every 3 min until 10 times after acid stimulation with a 500-mg vitamin C pill. The maximum apparent diffusion coefficient (ADC) in the parotid glands (pADCmax) and time to peak ADC in the parotid glands (pTmax) during stimulation were obtained. ADC values at every time point and the peak value of ADC were compared between the two groups and statistically analyzed.

Results

The ADC values in the parotid gland in the resting state in the patient group were slightly lower than those in the healthy controls ((1.02 ± 0.08) × 10−3 mm2/s vs. (1.11 ± 0.09) × 10−3 mm2/s, p > 0.05). The ADCs in the healthy controls increased after stimulation until they gradually reached their peak. The ADCs in the patient group first decreased after stimulation and then gradually increased until they peaked. The pADCmax in the patient group was significantly lower than that in the healthy controls ((1.45 ± 0.08) × 10−3 mm2/s vs. (1.7 ± 0.06) × 10−3 mm2/s, p < 0.05). The peak ADCs in the parotid gland and relative signal intensity after acid stimulation were significantly correlated (r = 0.666, p < 0.05).

Conclusion

DW-MRI before and after acid stimulation is potentially useful for noninvasive prediction of diabetes-induced xerostomia severity. ADC value is a sensitive indicator of parotid gland dysfunction and may indirectly reflect the degree of this dysfunction caused by fat deposition.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Bakianian Vaziri P, Vahedi M, Mortazavi H, Abdollahzadeh S, Hajilooi M. Evaluation of salivary glucose, IgA and flow rate in diabetic patients: a case-control study. J Dent (Tehran). 2010;7:13–8.

    CAS  PubMed  Google Scholar 

  2. Wang B, Du J, Zhu Z, Ma Z, Wang S, Shan Z. Evaluation of parotid salivary glucose level for clinical diagnosis and monitoring type 2 diabetes mellitus patients. Biomed Res Int. 2017;2017:2569707.

    PubMed  PubMed Central  Google Scholar 

  3. Huang DL, Chan KC, Young BA. Poor oral health and quality of life in older U.S. adults with diabetes mellitus. J Am Geriatr Soc. 2013;61:1782–8.

    Article  PubMed  Google Scholar 

  4. Lilliu MA, Loy F, Cossu M, Solinas P, Isola R, Isola M. Morphometric study of diabetes related alterations in human parotid gland and comparison with submandibular gland. Anat Rec (Hoboken). 2015;298:1911–8.

    Article  PubMed  Google Scholar 

  5. Molania T, Alimohammadi M, Akha O, Mousavi J, Razvini R, Salehi M. The effect of xerostomia and hyposalivation on the quality of life of patients with type II diabetes mellitus. Electron Physician. 2017;9:5814–9.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Carda C, Mosquera-Lloreda N, Salom L, Gomez de Ferraris ME, Peydró A. Structural and functional salivary disorders in type 2 diabetic patients. Med Oral Patol Oral Cir Bucal. 2006;11:E309–14.

    PubMed  Google Scholar 

  7. Maciejczyk M, Matczuk J, Żendzian-Piotrowska M, Niklińska W, Fejfer K, Szarmach I, Ładny J, Zieniewska I, Zalewska A. Eight-week consumption of high-sucrose diet has a pro-oxidant effect and alters the function of the salivary glands of rats. Nutrients. 2018;10:1530.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Little M, Schipper M, Feng FY, Vineberg K, Cornwall C, Murdoch-Kinch CA, Eisbruch A. Reducing xerostomia after chemo-IMRT for head-and-neck cancer: beyond sparing the parotid glands. Int J Radiat Oncol Biol Phys. 2012;83:1007–14.

    Article  PubMed  Google Scholar 

  9. Eisbruch A, Rhodus N, Rosenthal D, et al. How should we measure and report radiotherapy-induced xerostomia? Semin Radiat Oncol. 2003;13:226–34.

    Article  PubMed  Google Scholar 

  10. Feen Rønjom M. Radiation-induced hypothyroidism after treatment of head and neck cancer. Dan Med J. 2016;63:B5213.

    PubMed  Google Scholar 

  11. Riyaz MA. Diagnostic salivary gland imaging - a review. Integr J Med Sci. 2021;8:296.

    Google Scholar 

  12. Habermann CR, Gossrau P, Kooijman H, Graessner J, Cramer MC, Kaul MG, Reitmeier F, Jaehne M, Adam G. Monitoring of gustatory stimulation of salivary glands by diffusion-weighted MR imaging: comparison of 1.5T and 3T. AJNR Am J Neuroradiol. 2007;28:1547–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Reda R, Zanza A, Mazzoni A, Cicconetti A, Testarelli L, Di Nardo D. An update of the possible applications of magnetic resonance imaging (MRI) in dentistry: a literature review. J Imaging. 2021;7:75.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kato H, Kanematsu M, Toida M, Kawaguchi T, Shibata T, Kajita K, Hoshi H. Salivary gland function evaluated by diffusion-weighted MR imaging with gustatory stimulation: preliminary results. J Magn Reson Imaging. 2011;34:904–9.

    Article  PubMed  Google Scholar 

  15. Zhang Y, Ou D, Gu Y, He X, Peng W. Evaluation of salivary gland function using diffusion-weighted magnetic resonance imaging for follow-up of radiation-induced xerostomia. Korean J Radiol. 2018;19:758–66.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Zhou N, Chu C, Dou X, Li M, Liu S, Zhu L, Liu B, Guo T, Chen W, He J, Yan J, Zhou Z, Yang X, Liu T. Early evaluation of irradiated parotid glands with intravoxel incoherent motion MR imaging: correlation with dynamic contrast-enhanced MR imaging. BMC Cancer. 2016;16:865.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Chao KS, Deasy JO, Markman J, et al. A prospective study of salivary function sparing in patients with head-and-neck cancers receiving intensity-modulated or three-dimensional radiation therapy: initial results. Int J Radiat Oncol Biol Phys. 2001;49:907–16.

    Article  CAS  PubMed  Google Scholar 

  18. Habermann CR, Cramer MC, Graessner J, Gossrau P, Reitmeier F, Fiehler J, Schoder V, Jaehne M, Adam G. Functional imaging of parotid glands: diffusion-weighted echo-planar MRI before and after stimulation. Rofo. 2004;176:1385–9.

    Article  CAS  PubMed  Google Scholar 

  19. Lima-Aragão MV, de Oliveira-Junior JJ, Maciel MC, Silva LA, do Nascimento FR, Guerra RN. Salivary profile in diabetic patients: biochemical and immunological evaluation. BMC Res Notes. 2016;9:103.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Sashikumar R, Kannan R. Salivary glucose levels and oral candidal carriage in type II diabetics. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:706–11.

    Article  PubMed  Google Scholar 

  21. Zhang Q, Wei YM, Qi YG, Li BS. Early changes in apparent diffusion coefficient for salivary glands during radiotherapy for nasopharyngeal carcinoma associated with xerostomia. Korean J Radiol. 2018;19:328–33.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Merlo C, Bohl L, Carda C, Gómez de Ferraris ME, Carranza M. Parotid sialosis: morphometrical analysis of the glandular parenchyme and stroma among diabetic and alcoholic patients. J Oral Pathol Med. 2010;39:10–5.

    Article  PubMed  Google Scholar 

  23. Aitken-Saavedra J, Rojas-Alcayaga G, Maturana-Ramírez A, Escobar-Álvarez A, Cortes-Coloma A, Reyes-Rojas M, Viera-Sapiain V, Villablanca-Martínez C, Morales-Bozo I. Salivary gland dysfunction markers in type 2 diabetes mellitus patients. J Clin Exp Dent. 2015;7:e501–5.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Carda C, Carranza M, Arriaga A, Díaz A, Peydró A, Gomez de Ferraris ME. Structural differences between alcoholic and diabetic parotid sialosis. Med Oral Patol Oral Cir Bucal. 2005;10:309–14.

    PubMed  Google Scholar 

  25. Gupta A, Ramachandra VK, Khan M, Jha KS, Vedaraju KS, Channaiah NA. A cross-sectional study on ultrasonographic measurements of parotid glands in type 2 diabetes mellitus. Int J Dent. 2021;2021:5583412.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Chen S, Paul BC, Myssiorek D. An algorithm approach to diagnosing bilateral parotid enlargement. Otolaryngol Head Neck Surg. 2013;148:732–9.

    Article  PubMed  Google Scholar 

  27. Thoeny HC, De Keyzer F, Boesch C, Hermans R. Diffusion-weighted imaging of the parotid gland: influence of the choice of b-values on the apparent diffusion coefficient value. J Magn Reson Imaging. 2004;20:786–90.

    Article  PubMed  Google Scholar 

  28. Zhang Y, Ou D, Gu Y, He X, Peng W, Mao J, Yue L, Shen X. Diffusion-weighted MR imaging of salivary glands with gustatory stimulation: comparison before and after radiotherapy. Acta Radiol. 2013;54:928–33.

    Article  PubMed  Google Scholar 

  29. Ries T, Arndt C, Regier M, Graessner J, Cramer MC, Reitmeier F, Jaehne M, Adam G, Habermann CR. Value of apparent diffusion coefficient calculation before and after gustatory stimulation in the diagnosis of acute or chronic parotitis. Eur Radiol. 2008;18:2251–7.

    Article  CAS  PubMed  Google Scholar 

  30. Loimu V, Seppälä T, Kapanen M, Tuomikoski L, Nurmi H, Mäkitie A, Tenhunen M, Saarilahti K. Diffusion-weighted magnetic resonance imaging for evaluation of salivary gland function in head and neck cancer patients treated with intensity-modulated radiotherapy. Radiother Oncol. 2017;122:178–84.

    Article  PubMed  Google Scholar 

  31. Thoeny HC, De Keyzer F, Claus FG, Sunaert S, Hermans R. Gustatory stimulation changes the apparent diffusion coefficient of salivary glands: initial experience. Radiology. 2005;235:629–34.

    Article  PubMed  Google Scholar 

  32. Ren YD, Li XR, Zhang J, Long LL, Li WX, Han YQ. Conventional MRI techniques combined with MR sialography on T2-3D-DRIVE in Sjögren syndrome. Int J Clin Exp Med. 2015;8:3974–82.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Physical Examination Center, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, People’s Republic of China

    Xuemei Wang

  2. Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, People’s Republic of China

    Mingjia Niu

  3. Medical Imaging Center, Chongqing Yubei District People’s Hospital, Chongqing, People’s Republic of China

    Yuan Fang

  4. Medical Imaging Center, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, People’s Republic of China

    Shuang Wu

Authors
  1. Xuemei Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mingjia Niu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yuan Fang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shuang Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Mingjia Niu or Yuan Fang.

Ethics declarations

Ethics approval

The study was approved by the institutional review committee of Qinhuangdao Municipal No. 1 Hospital (Hebei Province, P.R. China).

Consent to participate

Written informed consent was obtained from all participants before study commencement.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, X., Niu, M., Fang, Y. et al. Evaluation of parotid gland function in type 2 diabetes patients using diffusion-weighted imaging before and after acid stimulation. Int J Diabetes Dev Ctries 43, 274–280 (2023). https://doi.org/10.1007/s13410-022-01055-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13410-022-01055-6

Keywords

Search

Navigation