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Introduction ⬇

A salivary scan gland, also known as a parotid scintigraphy, is a study that is helpful in the evaluation of swelling or masses in the parotid region. This imaging is done to detect blocked tumors of parotid or salivary glands and to diagnose Sjögren syndrome (a systemic autoimmune disease). The radionuclide injected intravenously is 99mTc pertechnetate. One of the limitations of the test is that it cannot furnish an exact preoperative diagnosis.

Procedure ⬆ ⬇

  1. Inject the radionuclide pertechnetate intravenously.

  2. Perform imaging immediately. There are three phases to imaging: blood flow, uptake or trapping mechanism, and secreting capability.

  3. Take images of the gland every minute for 30 minutes.

  4. If a secretory function test is being performed to detect blockage of the salivary duct, three quarters of the way through the test, ask the patient to suck on a lemon slice. If the salivary duct is normal, this causes the gland to empty. This is not done in studies undertaken for tumor detection.

  5. Alert patient that total test time is 45–60 minutes.

  6. See Chapter 1 guidelines for safe, effective, informed intratest care.

Clinical Implications ⬆ ⬇

  1. The reporting of a hot nodule amid normal tissue that accumulates the radionuclide is associated with tumors of the ducts, as in:

    1. Warthin tumor

    2. Oncocytoma

    3. Mucoepidermoid tumor

  2. The reporting of a cold nodule amid normal tissue that does not accumulate the radionuclide is associated with:

    1. Benign tumors, abscesses, or cysts, which are indicated by smooth, sharply defined outlines

    2. Adenocarcinomas, which are indicated by ragged, irregular outlines

  3. Diffuse decreased activity occurs in obstruction, chronic sialadenitis, or Sjögren syndrome.

  4. Diffuse increased activity occurs in acute parotitis.

Interventions ⬆ ⬇

Pretest Patient Care

  1. Explain the purpose, procedure, benefits, and risks of the scan.

  2. Reassure the patient that there is no pain or discomfort involved.

  3. Explain that lemon may be given to the patient to stimulate parotid secretion.

  4. Refer to standard NMI pretest precautions.

  5. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

Posttest Patient Care

  1. Review test results; report and record findings. Modify the nursing care plan as needed.

  2. Refer to standard NMI posttest precautions.

  3. Follow guidelines in Chapter 1 for safe, effective, informed posttest care.

Reference Values ⬆

Normal

No evidence of tumor-type activity or blockage of ducts

Normal size, shape, and position of the glands