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PubMed1990

[Imaging diagnosis of parotid diseases--a comparison of methods].

Thirty-five patients with parotid gland disorders were ultrasonographically examined with a "small parts" scanner, as well as with high-resolution computed tomography, and conventional and digital subtracted sialography. The results were compared with clinical, surgical, and pathomorphological data. In cases of parotid gland masses, the sensitivity of sonography, CT, and sialography was 100%, 81%, and 70% respectively, while in cases of sialadenitis, sensitivity was 38%, 50%, and 75%. The image-quality of digital subtracted sialography was superior to conventional sialography in 94% of cases, the same in 6%, and inferior in none of the cases. It is concluded that in all cases of parotid gland diseases ultrasound should be the first imaging method. If a tumor is confirmed, no further pretherapeutic imaging will be necessary in most cases. If a tumor is not confirmed, digital subtracted sialography should be employed to visualize inflammatory changes.

Adenoma↗
PubMedDate not supplied

Computed tomography and ultrasonography in parotid tumors.

To determine the most appropriate radiographic approach to parotid tumors, computed tomography (CT) was performed in 65 patients with 33 benign tumors, 19 malignant tumors, 3 abscesses and 10 other lesions with a clinical appearance of tumor. In 22 of the 65 cases CT-sialography and in 26 ultrasonography (US) were also performed. The mass was well recognized on CT without sialography in all patients, and the lesion was also well evaluated in all those examined with US. At CT-sialography the tumor was well shown, but this method made it difficult to differentiate a benign from a malignant lesion, because the character of the delineation and the border of the tumor were difficult to evaluate. It is concluded that US and CT without sialography are satisfactory for evaluating the parotid tumor, and the indication for CT-sialography is limited to those cases in which the tumor is demonstrated on US, but is unclear on conventional CT.

Adenoma, Pleomorphic↗
PubMed2007

Efficacy prediction of cevimeline in patients with Sjögren's syndrome.

The objective of this study was to examine the clinical and immunological factors influencing the efficacy of cevimeline hydrochloride hydrate (cevimeline) for the treatment of xerostomia in patients with Sjögren's syndrome (SS). Thirty primary SS patients who were medicated with cevimeline were enrolled in this study. Whole stimulated sialometry (WSS) was compared between pre- and posttreatment points (4 weeks after oral cevimeline administration) and the increment rate of WSS was calculated. Multiple regression was employed to examine the relative contributions of the clinical and immunological factors, including age, pretreatment WSS, duration of disease, sialography, minor salivary gland biopsy, anti-Ro/SS-A antibodies, anti-La/SS-B antibodies, and antibodies to muscarinic type 3 receptors to the posttreatment WSS. Patients with normal sialography findings, negative minor salivary gland biopsy, and absence of anti-La/SS-B antibodies had significantly higher increment rates of WSS compared with those with positive findings (p=0.042, 0.002, and 0.018, respectively). Results of the multiple regression analysis showed that sialography (coefficient=-0.867, p=0.004) and minor salivary gland biopsy (coefficient=-0.869, p=0.003) had significant associations with the posttreatment WSS. Our preliminary results demonstrated the relationship between the effect of cevimeline on saliva secretion and the degree of salivary gland destruction evaluated by sialography and histopathological findings in the labial minor salivary glands. These diagnostic approaches could provide useful prognostic information on the efficacy of cevimeline in SS patients.

Adult↗
PubMed1992

Accuracy in the diagnosis of parotid tumours.

Parotid lesions are often not easily classified. Important information is gathered by conventional and instrumental investigation. But these data are often insufficient to make a correct diagnosis. The authors have compared these techniques. In particular, they have evaluated their accuracy in identification of site and histology. 60 patients with parotid tumours underwent the same instrumental diagnostic techniques (echography, sialography, computed tomography and fine needle aspiration biopsy). In regard to the identification of the site, the highest percentage was achieved by computed tomography (98%). Echotomography has shown an accuracy of 83%, and sialography 87%. Fine needle aspiration biopsy has allowed the definition of the histiotype in 98% of cases. Computed tomography, echotomography and sialography have not allowed the definition of histiotype in malignant tumours, but in the case of benign tumours computed tomography has permitted a diagnosis in 29 cases (57% of benign tumours). Echotomography and sialography in 25 (49%) and 26 cases (51%), respectively.

Adenocarcinoma↗
PubMed1986

Sarcoidosis of the parotid gland.

The clinical and radiological features of parotid-gland sarcoidosis in 22 patients are presented. This occurred in association with systemic disease as painless, diffuse and nonnodular parotid swelling. Conventional sialography usually demonstrated normal proximal ducts, a few fragile distal ducts and non-specific parenchymal nodules. Computed tomography, with or without simultaneous sialography, defined and characterised such nodules and demonstrated normal periparotid anatomy. Sialography contributes little additional information to thorough clinical examination in non-nodular or multinodular glands. However, solitary nodules appear to be better investigated by sialography, CT and CT-guided aspiration, thereby allowing diagnosis and direct medical therapy and avoiding surgery. Ultrasonography and nuclear scintigraphy were of little value in this study.

Adult↗
PubMed1999

[The value of sialo-MRI in the study of salivary gland duct pathology].

Usual imaging diagnostic for salivary glands is sialography. Sialography is not stripped of disadvantages and failures. The MRI-sialography is an examination which is carried out without any injection of contrast's product (without catheterization or intravenous injection). It is thus noninvasive and painless. The complete study of salivary gland and its ducts is always possible and could not be blocked by local or loco-regional conditions. It allows exploration of several salivary glands in the same time. We think that the MRI-sialography must find its place in the diagnosis arsenal for salivary pathology in spite of its current handicaps represented by its cost and the difficulty of access to the apparatuses.

Contrast Media↗
PubMed1987

[Sialographic and sonographic diagnosis of salivary gland diseases].

The diagnostic value of sialography and ultrasonography was studied retrospectively in 130 patients with diseases of the salivary gland. In the diagnosis of tumours (sensitivity: 97.5% vs 52.5%), acute inflammatory diseases (sensitivity: 70% vs 40%) and abscesses (sensitivity: 100% vs 25%) ultrasound was more accurate than sialography. Even in the diagnosis of calculi, ultrasound gave good results (sensitivity: 71.4%) and should be performed before the more invasive sialography technique. In chronic inflammatory diseases, sialography continues to be the technique of choice.

Abscess↗
PubMed2003

Comparison of lacrimal and salivary gland involvement in Sjögren's syndrome.

OBJECTIVES: To determine the performance of different tear and salivary tests applied in Sjögren's syndrome (SS) and to disclose how these tests relate to common serologic tests in SS. DESIGN: In addition to the routine ocular and oral tests for diagnosing SS (Schirmer test, rose bengal score, unstimulated whole saliva flow, and parotid sialography), tear breakup time and flow rate of glandular saliva (parotid and submandibular-sublingual [SM/SL]) were evaluated in patients referred for diagnosis of SS. Patients were categorized into primary SS, secondary SS, and non-SS groups according to the revised European classification criteria for SS. SETTING: Referral center. PATIENTS: Referred sample of 80 consecutive patients. MAIN OUTCOME MEASURE: Correlation between ocular and salivary measures. RESULTS: Breakup time performed insufficiently in diagnosing SS, as opposed to the rose bengal score. In patients with primary and secondary SS, a clear correlation was noted between tear and saliva quality and secretion rate, and between the rose bengal score and parotid sialography. Increased rose bengal scores also correlated significantly with hyperglobulinemia and presence of SS-B antibodies in serum, with duration of subjective eye dryness, and with decreased tear-gland function. With regard to the oral tests, whole, parotid, and SM/SL salivary flow decreased significantly with increasing duration of oral complaints, with the stimulated SM/SL flow rate showing the strongest decrease and being more specific in diagnosing SS. Also, parotid sialography was more specific in excluding patients without SS than the commonly applied diagnostic criterion of secretion of unstimulated whole saliva. CONCLUSIONS: The rose bengal score remains the eye test of choice, as it has the highest specificity for SS. Hyperglobulinemia and especially positive serologic findings for SS-B may warrant close monitoring of the eyes, since these serum findings appear to relate to the severity of ocular surface damage. Parotid sialography and stimulated secretion of SM/SL saliva are more specific in diagnosing SS than unstimulated secretion of whole saliva.

Antibodies↗
PubMed1986

The salivary gland component of Sjögren's syndrome: an evaluation of diagnostic methods.

The diagnostic value of sialography, scintigraphy, sialometry, and labial salivary gland biopsy--as indicators of salivary gland dysfunction in Sjögren's syndrome (SS)--was evaluated in 41 patients suspected of having SS. In about 70% of the cases, each of the four examinations showed changes that could indicate a salivary gland component of SS. However, the disease specificity of sialographic and scintigraphic examinations was low. Although the specificity of the labial salivary gland biopsy examination is considered high, our study revealed some cases in which a focus score of 1 to 3 was not accompanied by abnormal changes in either sialometry, sialography, or scintigraphy. At a focus score of more than 3, a fair amount of agreement on the results of the various diagnostic procedures was found. Because labial salivary gland examination shows only minor salivary glands and sialography and scintigraphy include only major salivary glands, variance between different diagnostic procedures is expected. This indicates a potential diagnostic role for sialographic and scintigraphic examination when the labial salivary gland biopsy is insufficient.

Adult↗
PubMed2006

[Imaging of salivary lithiasis].

Lithiasis is the most common disease of salivary glands after mumps. The purpose of this review is to analyze the respective role of the different available imaging techniques for the diagnosis of lithiasis and related complications since the treatment of salivary lithiasis has evolved with the emergence of minimally invasive and non surgical techniques. In spite of its limitations, US represents an excellent first line imaging technique because it is non-invasive and widely available. Non contrast helical CT with multiplanar reconstructions seems to be the gold standard for the diagnosis of lithiasis, especially when small and poorly calcified since these may not be visible on standard radiographs. CT allows accurate characterization of the number and position of lithiasis. MR Sialography is increasingly replacing the more invasive conventional sialography for the non invasive visualization of the ductal system of major salivary glands even though conventional sialography has a higher spatial resolution.

Diagnostic Imaging↗
PubMed1988

Scintigraphic evaluation of the salivary glands in patients with Sjögren's syndrome.

The clinical value of salivary gland scintigraphy (RI-sialography) was studied in 11 cases with definite Sjögren's syndrome. Time-activity curves which were obtained from computer-assisted analysis of RI-sialography were classified into 4 types (N:normal type, M:median type, F:flat type, S:sloped type), and the efficacy of scintigraphy in evaluating salivary gland function and the relationship between time-activity curves and other diagnostic methods are discussed. Flattened time-activity curves such as F- or S-type were more often seen in submandibular glands than in parotid glands. Flattened curves were not seen in the early stage of the inflammatory process; conversely, when we found a flattened curve, it suggested a wide destruction of the salivary gland tissues. Correlation between time-activity curve and sialography showed 90.9%, and correlation between time-activity curve and histopathological change in the minor salivary gland of the lower lip also showed 90.9%.

Adult↗
PubMed2006

Infantile recurrent parotitis: follow up study of five cases and literature review.

UNLABELLED: Recurrent parotitis (RP) is defined as recurrent parotid inflammation, generally associated with non-obstructive sialectasis of the parotid gland. It is a rare condition, and its etiology remains an enigma. AIM: The purposes of the present study were (1) to relate the follow up of five RP cases; (2) to examine the role of sialography and ultrasound in diagnosis and follow up; and (3) to make a literature review. STUDY DESIGN: Series review. MATERIAL AND METHOD: We reviewed all recurrent parotitis cases from the files of the Otolaryngology Division at University of Sao Paulo, Brazil. The criteria for inclusion were at least two years of evolution and more than one year and a half follow-up in our service. We included five children in the study. Sialography was performed in the first evaluation and sonography was executed annually. Recurrent parotitis showed male predominance, and affected mainly children between the ages of 3 and 6. Frequency of crisis improved with time in all cases. Sialography showed sialectasis aspect in the affected glands and sonographic exams demonstrated hypoechoic and heterogeneous internal echoes. One case showed regression of ultrasound changes after clinical improvement.

Adolescent↗
PubMed1989

Technetium-99m pertechnetate and gallium-67 imaging in salivary gland disease.

Thirty-two patients with salivary gland tumors or sialadenitis were studied with Tc-99m pertechnetate and Ga-67 imaging and, in some instances, sialography. The diagnostic algorithm presented allows the correct categorization of the salivary gland pathology in the vast majority of patients. The patients were studied serially with Tc-99m pertechnetate, Ga-67 and in certain situations sialography (or CT-sialography). Use of the algorithm can distinguish benign salivary tumors from malignant tumors and malignant tumors from inflammatory disease. The limitations and pitfalls of interpretation are discussed.

Adult↗
PubMed1980

The combined CT-sialogram.

Parotid sialograms were obtained in 18 patients. Immediately following sialography, computed tomography (CT) was performed. The results of the combined CT-sialography were compared to those of sialography alone, and are presented here. CT-sialograms allowed for confident preoperative differentiation of deep-lobe parotid masses (in nine pateints) and parapharyngeal masses (in five patients). In four patients, the lesions involved both the parotid gland and the adjacent soft tissue. There were no errors in diagnosing malignancies (seven malignant masses, 11 benign), and subtle masses, which may be easily missed on sialograms, were more clearly seen on the combined study. With the CT-sialograms, the extent of metastatic involvement of adjacent structures was also more easily determined.

Humans↗
PubMed2000

Major salivary gland imaging.

The algorithm for imaging the salivary glands depends on the clinical scenario with which the patient presents to the clinician. Because of the importance of identifying small calculi in the gland or salivary duct as the cause of the symptom complex, nonenhanced computed tomography is often the best initial study for the evaluation of the painful gland. If an infiltrative neoplasm is highly suspected, nonenhanced and enhanced magnetic resonance (MR) imaging may be superior in demonstrating perineural, meningeal, and skull base invasion. Sialography is reserved for the evaluation of chronic sialadenitides unrelated to sialolithiasis. Thin-section MR techniques for MR sialography may soon replace conventional sialography.

Humans↗
PubMed1989

[Evaluation of photographic subtraction images obtained from sialograms].

Photographic subtraction used in the examination of salivary glands was compared with conventional sialography. Subtraction images obtained from the duct system of parotid glands demonstrated the same images as were obtained by conventional sialography. In duct system of the submaxillary glands, however, the conventional sialograms were clearer than those images obtained by subtraction procedures. Subtraction images could provide the outward form of salivary glands, especially in the parotid glands. In most cases, sialography with subtraction provides valuable informations in diagnosing salivary gland diseases. But, the results showed that the necessity of applying this modality must be examined carefully.

Humans↗
PubMed1989

[Combined diagnosis of parotid masses].

Computed tomography (CT), ultrasonography, sialography, and 99mTc scintigraphy were applied before operation to 108 patients with parotid masses. The results of each technique and the combined study of them were compared with the pathological diagnosis. Ultrasonography was found to be a very effective diagnostic aid in determining the presence of space-occupying lesion in the parotid. CT was the best technique to provide adequately reliable informations regarding the location of the tumor and the relationship between tumor and surrounding tissues. For diagnosing the nature of tumors, ultrasonography combined with sialography was reliable. 99mTc scintigraphy was better than other techniques in diagnosis of adenolymphoma. The diagnostic accuracy of combined diagnosis (90.7%) was higher than those of ultrasonography (83%), CT (80.5%), sialography (79%), and 99mTc scintigraphy (13.9%) alone. The advantage of combined diagnosis was particularly obvious for the diagnosis of low-grade malignant tumors.

Adenolymphoma↗
PubMed1989

[Radiologic evaluation of cervical metastatic adenopathy].

A radiologic evaluation in nine patients with cervical adenopathy because of metastatic disease at a known or unknown primary site, inflammatory lymphadenitis or with masses simulating with cervical adenopathy was done. All patients were examined normally by an oral and maxillofacial or E.N.T. surgeon before the radiologic evaluation with CT, ultrasonography and/or sialography. CT was done in seven out of nine patients as the unique technique or in combination with ultrasonography and/or sialography, while ultrasonography was used in two of the cases as a unique imaging technique and in one case in combination with a CT examination, without any intravenous contrast administration. A primary site was diagnosed in five cases, while in a sixth case was not diagnosed. In an eighth case of submandibular nodal enlargement, the diagnosis of Hodgkin's disease was established after a biopsy. For the last two cases the diagnosis of tuberculous cervical lymphadenopathy was confirmed. From the above cases it is clearly shown that computerized tomography, especially with intravenous contrast administration, ultrasonography and sialography in some of the cases, are necessary as routine examinations, before a diagnosis of cervical metastatic disease is to be done.

Head and Neck Neoplasms↗