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CT sialography and conventional sialography in the investigation of parotid masses.

In a 3-year period computed tomography (CT), both plain and in combination with sialography, and conventional sialography were used in 59 patients who had or were suspected of having salivary gland tumors, with special regard to attenuation in different tumors and the tumor borders. The diagnostic information obtained with CT sialography and conventional sialography was evaluated. The most valuable advantage of parotid CT sialography is the possibility of demonstrating the tumor and its actual size and relationship to the surrounding structures. The differentiation between benign and malignant tumors must be based mainly on clinical investigation and fine-needle biopsy. Conventional sialography may be an important complement to CT sialography because of its ability to illustrate the morphology of the finest ducts.

Adenoma

[The value of digital subtraction sialography compared to conventional sialography, salivary gland sonography and surgical findings].

In a prospective study DSA sialography, conventional sialography (100mm technique) and sonography of the salivary glands were performed in 124 patients. The results of imaging could be correlated with those of operation and/or histology in 70 patients. Performing sialography in only one projection DSA sialography is superior to the conventional technique. The results of DSA are equivalent to those of conventional sialography in more than one projection. DSA sialography is the method of choice demonstrating salivary calculi, whereas sonography is superior to DSA sialography in the detection of tumors. In the diagnosis of chronic inflammation of the salivary glands DSA is slightly superior to the other imaging modalities.

Adolescent

Digital subtraction sialography, conventional sialography, high-resolution ultrasonography and computed tomography in the diagnosis of salivary gland diseases.

Forty-one patients with salivary gland disorders have been evaluated by digital subtraction sialography, conventional sialography, high-resolution ultrasonography and computed tomography, and the results compared with clinical, surgical and pathomorphological data. In the case of salivary gland masses, the sensitivity of ultrasonography, CT and digital subtraction sialography was 100%, 82% and 71%, respectively, while in the case of sialadenitis, the respective figures were 54%, 69% and 85%. The image quality of digital subtraction sialography was superior to that of conventional sialography in 80%, equal in 16%, and inferior in 3% of the examinations. We conclude that in all cases of salivary gland diseases ultrasound should be the first imaging procedure. If a tumour is not confirmed, digital subtraction sialography should be employed to visualise inflammatory changes, while in most cases of salivary gland masses no further imaging will be necessary.

Humans

Sialography in salivary gland disease.

Ninety-six consecutive patients underwent sialography over a 10 year period at North Tees District General Hospital; there were 68 parotid and 28 submandibular examinations. Patients were divided into two groups: group 1, patients with symptoms but no clinical signs (n = 27); group 2, patients with swelling of the salivary gland (n = 69). Results showed that sialography was of considerable value in group 1 patients demonstrating pathology in 33 per cent (9/27 patients). In patients with a suspected, but unusually situated, parotid tumour (n = 20) sialography was confirmatory in 10 patients but the technique failed in four, gave a false negative result in four and would seem to be of limited value. In the remaining patients in group 2 with diffuse glandular swelling (n = 49) the main contribution of sialography was in demonstrating sialectasia (9), duct strictures (4) and non-opaque parotid calculi (2), but even in this group of patients 35 per cent (17/49 patients) of the examinations were normal. When submandibular calculi were demonstrable on plain radiography sialography contributed no further relevant information.

Adolescent

[Value of sonography and sialography in the diagnosis of salivary gland diseases].

134 patients with diseases of the salivary glands who underwent both real-time sonography and sialography were analyzed retrospectively. Using the two imaging methods a correct diagnosis was established in 92.5% of the patients. Masses of the salivary glands were detected in 98% (60/61) of the cases with the ultrasound examination, in 90% with sialography. The exact differentiation between a peripherally placed intrinsic lesion and an extrinsic mass that is intending the peripheral salivary gland contour often showed to be difficult as well with sialography and sonography. A chronic obstructive or non-obstructive sialadenitis could be correctly diagnosed in 91% of the cases with sialography, but only in 65% using sonography. The results demonstrate the complementary role of sonography and sialography in evaluating salivary gland disease.

Adult

[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

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

[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

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

Diagnosis of salivary gland disease using ultrasound and sialography: a comparison.

Thirty-one patients with a suspected inflammatory or neoplastic lesion of a major salivary gland were investigated with ultrasound, and in 27 of them sialography was carried out in addition. The results of the diagnostic procedures were compared. Lesions of the gland parenchyma and intra and extra-glandular duct ectasia were demonstrated by ultrasound. Salivary stones were demonstrated by this method and ultrasound allowed assessment of periglandular structures. Sialography is indispensable for detailed assessment of the salivary ducts. The present report shows that ultrasound is superior to sialography in the assessment of salivary gland disease. The investigation is non-invasive, cheap, and requires neither contrast nor radiation and can be repeated at will for follow-up.

Adenolymphoma

Salivary gland scintigraphy--a suitable substitute for sialography?

By comparing 27 patients who had both scintigraphy and sialography in the assessment of salivary gland disease, scintigraphy has been shown to correlate well with abnormal sialograms. It is suggested that scintigraphy could become the initial screening procedure in the assessment of salivary gland disease. A normal scintiscan is unlikely to miss significant pathology (as demonstrated by sialography), but sialography must always be performed if there is a suspicion of duct obstruction on scintigraphy. Patients suspected of focal salivary gland pathology such as tumour have not been investigated. The series documents the findings in patients who presented with facial pain, swelling or xerostomia suggesting sialadenitis, duct occlusion or Sjögren's syndrome.

Adolescent

Clinical application of computerized continuous-infusion pressure-monitored sialography.

The clinical application of computerized continuous-infusion pressure-monitored sialography using an aqueous contrast medium during the investigation of 296 salivary glands is described. A comparison between the pressure changes and the sialographic features revealed a significant (P less than 0.001) correlation between raised filling pressure (greater than 60 mmHg) and the presence of an obstructive lesion (stricture, mucous plug, sialolith). Occasionally a raised filling pressure was observed although the associated sialography films were normal. The sensitivity of the technique was 86.4%. It is concluded that the monitoring of pressure changes occurring during sialography can alert the clinician to the presence of high filling pressure and may also provide additional evidence of obstructive changes within salivary glands.

Adolescent

[Clinical value of sialography in digital and conventional imaging technique].

Digital subtraction sialography offers a new technique for the diagnosis of salivary gland disease. The basis of this technique is the removal of superimposed bony structures. Ninety-one patients (4-77 years old) with acute and chronic inflammatory disorders, chronic sialectasis, chronic sialolithiasis and tumours of various types underwent sialography using the digital subtraction technique. In addition, conventional sialography using a 100 mm camera and high resolution ultrasonography was performed. The results were compared with the histopathology and intraoperative findings. The digital subtraction technique is superior in recognition of inflammatory changes and chronic sialolithiasis, whereas ultrasonography is more sensitive in diagnosis and localization of tumours.

Adolescent

[Diagnosis of tumors of the parotid gland by sialography and saialoscintigraphy. A comparative study on 49 patients (author's transl)].

169 patients with different diseases of the salivary glands were examined by means of sialography and sialoscintigraphy. The results of these examinations were analysed by a blindfold test. The sialographic diagnosis was correct for 47 of 49 tumors checked by histologic examinations. There is no specific criterium for the scintigraphic determiation of a tumor; there are concentrations as well as filling defects and retentions. The correct side, however, was found by scintigraphy in 46 cases. Only if a Warthin's tumor is suspected, the diagnosis can be confirmed by scintigraphy if a concentration is found. Generally, sialoscintigraphy should only be executed if sialography has technically failed. A distinction by means of sialography of benign and malignant tumors is not possible.

Adolescent