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PubMed1979

[Salivary scintigraphy and sialography. Comparison of results in various common disorders].

We recommend the association of scintigraphy and sialography in salivary glands pathology. The obtained results of both methods are very often complementary or convergent. In case of sialadenitis or dry mouth, it happens that results diverge, but these differences can be explained if one remembers the anatomo-physiological alterations. To prevent a false positive result of atrophy. The scintigraphy must always be realized before sialography. N.B. "Scintigraphy" means isotopic sialography. "Sialography" means conventional sialography.

Humans↗
PubMed1984

Choice of contrast medium in sialography.

Contrast media used for sialography were originally developed for other medical applications. Therefore, it was considered desirable to investigate the properties of these substances for use in sialography. Eleven radiopaque substances were selected, and their properties for sialography were studied. An in vitro study was made to determine their contrast qualities and their rate of evacuation after the sialographic examination. In animal experiments the possible harmful effects of the media on salivary gland tissues were studied. Moreover, the effects of the radiopaque material on the extraglandular tissues--which are important in understanding the consequences of spilling into these tissues--were investigated. The results of this study were compared with data from the literature. Conray 80, Amipaque 440, Lipiodol UF, Myodil, and Duroliopaque appear to be the media most suited for sialography, provided glandular overfilling is avoided. A prolonged clinical study is advised for a further selection from these agents.

Animals↗
PubMed2005

[MR-sialography: optimisation and evaluation of an ultra-fast sequence in parallel acquisition technique and different functional conditions of salivary glands].

PURPOSE: To optimise a fast sequence for MR-sialography and to compare a parallel and non-parallel acquisition technique. Additionally, the effect of oral stimulation regarding the image quality was evaluated. MATERIAL AND METHODS: All examinations were performed by using a 1.5-T superconducting system. After developing a sufficient sequence for MR-sialography, a single-shot turbo-spin-echo sequence (ss-TSE) with an acquisition time of 2.8 sec was used in transverse and oblique sagittal orientation in 27 healthy volunteers. All images were performed with and without parallel imaging technique. The assessment of the ductal system of the submandibular and parotid gland was performed using a 1 to 5 visual scale for each side separately. Images were evaluated by four independent experienced radiologists. For statistical evaluation, an ANOVA with post-hoc comparisons was used with an overall two-tailed significance level of P =.05. For evaluation of interobserver variability, an intraclass correlation was computed and correlation >.08 was determined to indicate a high correlation. RESULTS: All parts of salivary excretal ducts could be visualised in all volunteers, with an overall rating for all ducts of 2.26 (SD +/- 1.09). Between the four observers a high correlation could be obtained with an intraclass correlation of 0.9475. A significant influence regarding the slice angulations could not be obtained (p = 0.74). In all healthy volunteers the visibility of excretory ducts improved significantly after oral application of a Sialogogum (p < 0.001; eta (2) = 0.049). The use of a parallel imaging technique did not lead to an improvement of visualisation, showing a significant loss of image quality compared to an acquisition technique without parallel imaging (p < 0.001; eta (2) = 0.013). CONCLUSION: The optimised ss-TSE MR-sialography seems to be a fast and sufficient technique for visualisation of excretory ducts of the main salivary glands, with no elaborate post-processing needed. To improve results of MR-sialography, it is reasonable to use an oral Sialogogum.

Computing Methodologies↗
PubMed2004

Ultrasonography of salivary glands in primary Sjogren's syndrome. A comparison with magnetic resonance imaging and magnetic resonance sialography of parotid glands.

OBJECTIVES: To evaluate ultrasonography (US) of salivary glands in primary Sjögren's syndrome (SS) and to compare US with parotid magnetic resonance (MR) imaging and MR sialography. METHODS: US examination of parotid, submandibular and sublingual glands was performed on 27 patients with primary SS, 27 healthy controls and 27 symptomatic controls without SS. The results were compared with parotid MR imaging and MR sialography and the clinical features of the patients. RESULTS: Salivary gland abnormalities, parenchymal inhomogeneity or adipose degeneration, were visualized in 21 (78%) SS patients, in one healthy control and in two symptomatic controls by US. Eighteen (67%) patients had changes in the parotid and submandibular glands and 8 (30%) changes in the sublingual glands. In the comparison, MR sialography was found to be the most sensitive method (96%), followed by MR imaging (81%) and US (78%), in detecting glandular changes. The specificity of US was 94%. The US and MR results were related to anti-Ro/SSA positivity but not to saliva secretion. The focus scores were related only to parotid MR imaging findings. CONCLUSIONS: US, MR imaging and MR sialography with modern technology have reached such a good accuracy in visualizing glandular structural changes that they are promising alternatives to the conventional invasive examinations in the diagnostics of SS.

Adolescent↗
PubMed1988

Salivary gland uptake of gallium-67 citrate after sialography.

Sialography may cause greatly increased Ga-67 activity within otherwise normal salivary glands. Five patients are presented in whom sialography with oily contrast material injected 8-26 days before Ga-67 imaging produced strongly positive examinations. In each patient it appears that sialography rather than pre-existing pathologic conditions accounted for the increased activity. Sialography-induced subclinical sialadenitis may be the mechanism for the phenomenon.

Adult↗
PubMed1996

The role of ultrasound in screening patients referred for sialography: a possible protocol.

In a prospective study, ultrasound examination of the salivary glands was performed in 31 consecutive patients referred for sialography. Good correlation between ultrasound and digital sialography was observed in 26 patients with only one false negative ultrasound in a patient with significant sialectasis. We recommend initial ultrasound examination in patients with symptoms suggesting an inflammatory lesion in the salivary glands. If this is normal or reveals a solid mass, sialography is not indicated. If ultrasound examination demonstrates the presence of calculi, duct dilatation, cystic elements or an enlarged gland, digital sialography should be performed to identify lesions in the main duct such as strictures or obstructing calculi.

Adolescent↗
PubMed1996

Is sialography effective in diagnosing the salivary component of Sjögren's syndrome?

Parotid sialography has been used for many years as a means of assessing salivary glands in Sjögren's syndrome (SS), and it is occasionally used as a diagnostic criterion for the salivary component of SS. To assess its diagnostic effectiveness, we reviewed studies in which sialography was applied to patients with SS and control subjects for the purpose of estimating its diagnostic sensitivity and specificity or comparing it with other means of assessing salivary glands. Sialography appears to be diagnostically less sensitive but more specific than salivary flow rate measurement and more sensitive but less specific than labial salivary gland (LSG) biopsy. Such calculations are based on the diagnosis of SS established in each study, but the various studies used widely different criteria to establish that diagnosis. Therefore, these calculations are not based on a consistent standard, and comparison between the calculations may be misleading, which underscores the need to develop internationally accepted diagnostic criteria for SS. Studies conducted so far have not shown that parotid sialography is either a sensitive indicator of the salivary component of SS or more closely associated than LSG biopsy with keratoconjunctivitis sicca, the only other component of primary SS with which ultimately to assess diagnostic specificity.

Humans↗
PubMed1993

Approach to the diagnosis of sialadenosis using sialography.

Since parotid swelling is the most informative symptom of sialadenosis, we examined parotid swelling with sialography as a means of diagnosing sialadenosis. An X-ray was taken from a fixed position relative to the body, using a focus film distance (FFD) of 70 cm. To determine an "index" of parotid swelling, the distance between the submandibular bone ridge and the end of the main duct was measured on X-ray. After examination of 30 normal parotids, abnormal swelling was defined as an "index" exceeding 1.9 cm. Sixteen of 24 patients suspected of having sialadenosis showed swelling exceeding 1.9 cm. Six of 7 patients who were histologically diagnosed with sialadenosis showed swelling in excess of 1.9 cm. Our method is reproducible and recurrence of parotid swelling correlating with sialadenosis can be objectively demonstrated. Furthermore, serum amylase levels in patients who were diagnosed with sialadenosis were measured before and after sialography. After sialography serum amylase levels increased remarkably higher than those of normal subjects. Thus if a patient with underlying diseases has an "index" over 1.9 cm and his serum amylase level after sialography increases remarkably, a diagnosis of sialadenosis is likely.

Amylases↗
PubMed2003

[MR Sialography].

Indications for sialography have became rare and radiologists are less and less experienced for salivary gland cannulation. MR Sialography allows opacification of salivary ducts without any cannulation and could replace residual indications for sialography. The purpose of this paper is to review the principle of the technique, the normal and pathologic aspects of MR Sialography and to emphasize advantages and limitations compared to other techniques.

Cost-Benefit Analysis↗
PubMed2003

[Analysis of parotid sialography and intervention in 78 cases of chronic pyogenic parotitis].

OBJECTIVE: To study the value of parotid sialography and intervention in the diagnosis and treatment of chronic pyogenic parotitis. METHODS: Undertake the technique of parotid sialography with 48% Lipiodol ultra-fluide (France) under X-ray upon 78 patients who were given systemic anti-infections and supporting treatments only with non-obvious-results, and classify all the cases into chronic obstructive (21 cases) and nonobstructive parotitis (57 cases) according to the results of sialography through microcatheter, then go on with bacterial culture and drug sensitivity test. Filling treatments were carried out on obstructive parotitis cases through the duct with mixed liquor consisting of 2% lidocanine, 1% methylviolet. In the same way, alpha-chymotrypsin, amikacin, lidocaine was used in nonobstructive cases. RESULTS: The cure rate of chronic obstructive parotitis was 80.95%, the cure rate of chronic nonobstructive parotitis was 87.72%. CONCLUSION: The method of parotid sialography and intervention in the diagnosis and treatment of chronic pyogenic parotitis is an effective way to treat chronic pyogenic parotitis.

Adolescent↗
PubMed1985

[Sialography, echography and computerized tomography in the study of the parotid region].

The diagnostic accuracy of sialography and ultrasonography (US) in the evaluation of parotid masses is evaluated. Furthermore the role of computed tomography (CT) in this pathology is discussed. In the personal experience US proved to be the best method in the recognition of a parotid tumor while sialography was superior in defining the intra or extraparotid site. The two investigations showed the same accuracy in the definition of benign or malignant nature of the mass. Therefore we consider US the only investigation in most instances; sialography could be performed when the site of the lesion is uncertain or an inflammatory lesion is suspected. CT is never the first investigation; its use is limited to a low number of cases, mainly for the evaluation of large masses and when the association US-sialography does not allow a sure diagnosis.

Adenolymphoma↗
PubMed1983

[Current role of sialography].

Computed tomography, ultrasonography and nuclear medicine are morphological techniques widely accepted in clinical practice. They are used together with plain film and sialography in the study of salivary glands pathology. In comparison with these techniques, the efficacy of sialography in different diseases is discussed and the diagnostic value of CT-sialography related to sialography alone is analyzed.

Humans↗
PubMed1999

3D T2-weighted fast spin-echo MRI sialography of the parotid gland.

The diagnostic value of 3D T2-weighted MRI sialography and 2D T2-weighted fast spin-echo (FSE) images for delineation of the normal duct system and characterisation of parotid gland duct pathology was compared in a prospective study. We studied eight healthy volunteers and 18 patients with pathology of the parotid gland (tumours in 3, sialolithiasis in 6, Sjögren's disease in 4, recurrent or chronic parotitis in 4, post-traumatic stricture of the main parotid duct in 1). A heavily T2-weighted 3D FSE sequence was compared with a conventional 2D T2-weighted FSE sequence. The normal main parotid duct was always visible on 3D sialography and seen in 68% of the 2D T2-weighted FSE studies. The diagnostic reliability of both sequences for diagnosis of luminal concretions in sialolithiasis and dilatation of the duct in duct stricture or chronic parotitis was equal, although slight intraglandular dilatation was appreciated only on 3D sialography. Extraductal pathology resulting in obstruction or displacement of ducts was better characterised on 2D T2-weighted images. However, 3D MRI sialography offered the advantage of postprocessing with overview images and multiple maximum-intensity projection images in any plane.

Adolescent↗
PubMed1997

Reliability of ultrasonography and sialography in the diagnosis of Sjögren's syndrome.

OBJECTIVE: The purpose of this study was to evaluate quantitatively observer performance with ultrasonography and sialography in the diagnosis of parotid gland involvement of Sjögren's syndrome. STUDY DESIGN: Sixty-four parotid gland sialograms and 65 ultrasonograms were prepared for observer performance experiments. They included both modalities in 24 Sjögren's syndrome and 19 nonspecific parotitis cases, 21 normal parotid gland sialograms, and 22 normal ultrasonograms in healthy volunteers. The images were randomly sequenced and presented to five observers who were asked to describe several findings and finally to determine the imaging diagnosis by ranking the abnormal features and the diagnosis on a five-point-rating scale. Observer performance was evaluated on the basis of the reliability of findings interpreted and the diagnostic accuracy of each modality from observers' rating scores. RESULTS: The diagnostic accuracy of sialography was very high, nearly perfect. The diagnostic accuracy of ultrasonography was lower than that of sialography, resulting from the lower incidence of characteristic findings in the disease groups and lower sensitivity on ultrasonography. In the differentiation of Sjögren's syndrome from the normal, however, the diagnostic accuracy of ultrasonography increased to 80% for all cases, and up to nearly 90% in the advanced sialographic stages. CONCLUSION: Ultrasonography is useful for the diagnosis of Sjögren's syndrome in the advanced stages. Taking the noninvasiveness of this technique into account we recommend first applying ultrasonography to the diagnosis of Sjögren's syndrome and performing sialography when no positive findings are detected on ultrasonography.

Analysis of Variance↗
PubMed2002

Virtual endoscopic view of salivary gland ducts using MR sialography data from three dimension fast asymmetric spin-echo (3D-FASE) sequences: a preliminary study.

OBJECTIVES: We performed magnetic resonance (MR) sialography of parotid gland and/or submandibular gland ducts using three-dimensional fast asymmetric spin-echo (3D-FASE) sequencing. The objective was to make three-dimensional (3D) reconstruction images and virtual endoscopic views of the parotid gland ducts using MR sialography data sets of 3D-FASE sequences. METHODS: We reviewed the MR sialography data sets with 3D-FASE sequencing of 10 control volunteers and six patients. Three-dimensional reconstruction images and virtual endoscopic views of the parotid gland and/or submandibular gland ducts were generated with maximum intensity projection (MIP), shaded surface display (SSD), and volume rendering techniques (VRT). RESULTS: The main parotid gland and/or submandibular gland ducts, large branches within the glands, and small branches were fairly well defined in a very short acquisition time on MR sialographic images with 3D-FASE sequencing in nine of the 10 healthy volunteers. The 3D-reconstruction images of the parotid gland ducts and/or submandibular gland ducts showed the entire length of the branch paths and complete images from all angles, and the virtual endoscopic views showed the endoluminal tracts of the main ducts and the large branches in nine. In the patient with Sjogren's syndrome, chronic sialoadenitis, and salivary calculi in the Wharton ducts, the MR sialographic images showed diffuse areas of punctate high signal intensity, dilatation of Stensen's duct, or stones of Wharton's duct, respectively. Furthermore, the 3D-reconstruction images of the salivary gland ducts showed the stenoses and stones in the branch paths and complete images from all angles, and the virtual endoscopic views showed the stenoses and stones in the endoluminal tracts of the main and large branches. CONCLUSIONS: Our initial experience showed that virtual MR endoscopy could be performed to observe the endoluminal tracts of parotid and submandibular glands. The clinical use of the virtual MR endoscopy for salivary gland ducts has not been established yet. Future applications of the 3D-reconstruction images and virtual endoscopic views using MR sialography data sets of 3D-FASE sequences are very attractive and further expansion of this field is expected.

Adolescent↗
PubMed1977

The value of sialography in the diagnosis of parotid tumors. A clinicopathological correlation.

The importance of sialography in the diagnostic evaluation of the condition of a patient with a parotid mass remains uncertain; some proponents advise use of sialography routinely, while others believe it to be worthless. To help resolve these conflicting opinions, a retrospective study of 40 patients was carried out that compared sialographical interpretations with respective surgical-histological findings. The results of this study show that generally reliable information, which may serve to influence therapeutic decisions concerning these patients, can be gleaned from sialography.

Humans↗
PubMed2006

3D MR sialography protocol for postradiotherapy follow-up of the salivary duct system.

PURPOSE: To develop and evaluate an MR sialography protocol that reproducibly images the parotid and submandibular ducts over time, in 3D. Such a protocol is needed in order to investigate the possible radiation-induced changes to the salivary ducts in patients receiving radiotherapy to the head-and-neck. MATERIALS AND METHODS: MR sialography was performed on a 1.5-T MR scanner. Sequence parameters were optimized on 11 healthy volunteers. A 3D water-selective turbo spin echo (TSE) pulse sequence (TR/TE = 6000 msec/190 msec), using a two-element circular surface coil was applied twice in one MR session. In order to assess the reproducibility, the same procedure was repeated four to six months later. The quality of the MR sialograms was measured subjectively by developing a visibility scoring system and objectively by the means of contrast-to-noise ratio (CNR) of the ducts vs. fat (CNR(duct-fat)). RESULTS: High-quality, 3D MR sialographic images were obtained. The quality of the MR sialograms and the subjective visibility score of the salivary ducts were constant over time. The CNR(duct-fat) varied between volunteers (standard deviation, SD 26%) but it was relatively constant per volunteer (SD 5%). CONCLUSION: The MR sialography protocol presented in this study provides good quality 3D imaging of the major salivary ducts, submandibular duct, and the parotid duct and it can be used for the comparison of the salivary duct system of an individual over time.

Head and Neck Neoplasms↗
PubMed1998

Advantage of appropriate K-edge filters for one-shot dual-energy subtraction sialography.

OBJECTIVES: To determine the optimal added filtration for use for one-shot dual energy subtraction sialography. METHODS: Test phantoms composed of bone and soft tissue materials were imaged with computed radiography using one-shot dual energy subtraction radiography. Eight different additional filter materials were compared with gadolinium contrast. Two numerical measures (absorption ratio and separation index) were used to compare the subtracted images obtained with the various filter/contrast combinations. The K-edge spectra were measured for each filter/contrast combination. A preliminary comparison of a 1.5 M iodine contrast medium with a 1.5 M gadolinium was performed using canine sialography. RESULTS: The gadolinium contrast/samarium filter combination had a larger separation index (P < 0.05). The same combination yielded better sialograms than iodine contrast. CONCLUSIONS: Samarium filter has an optimal k-edge for one-shot dual-energy sialography with gadolinium contrast.

Animals↗