ABSTRACT
The conventional sialography [CS] and minor salivary gland biopsy have been considered the cornerstones of the diagnosis of Sjogren's syndrome [SS]. However, they are invasive and with risk of complications to the patient. Magnetic resonance imaging [MRI] has been widely replacing conventional invasive examinations. They provide insufficient data for diagnosing and staging SS, because while they address the detection and diagnosis of parenchymal salivary gland disease they do not assess duct abnormalities. The introduction of magnetic resonance sialography [MRS] protocol was the first step towards non-ionizing non-invasive technique enables a more accurate assessment of the duct system. Moreover, it is postulated that the combined use of MRI and MRS is useful for the assessment of damaged salivary glands in SS. This preliminary study aimed to assess the role and efficacy of MRS and MRI in imaging the parotid gland in SS patients' and to compare their results with that of CS in the diagnosis and staging of SS. The parotid gland was examined by MRS, MRI and CS in 15 SS patients. Scoring system for overall branching pattern, ductal system staging, sialectasis for both CS and MRS was used. MRI scoring system for glandular parenchymal pattern, size and contour and lymph node was used. This revealed non-significant difference between CS and MRS findings in the diagnosis and staging of SS. Furthermore, no statistically significant correlation was found between the clinical and SS stage in both CS and MRS. On the other hand, a statistically significant positive correlation was found between the clinical findings and the MRI parenchymal stages. Moreover, MRS showed higher sensitivity and diagnostic accuracy values than CS. Combining the MRS and MRI abnormalities, 100% sensitivity diagnostic accuracy values were achieved in the diagnosis and staging of SS. The inter-observer agreement was higher in MRS than in CS and was perfect in MRI. In this preliminary study, MRS showed a higher sensitivity and accuracy in diagnosing and staging SS and may safely and securely replace CS. MRI and MRS give information on different aspects of glandular and duct pathology; therefore, both should be performed when examining the parotid glands in SS patients
Subject(s)
Humans , Female , Sjogren's Syndrome/diagnosis , Magnetic Resonance Imaging/methods , Sialography/methods , Comparative StudyABSTRACT
We evaluated in this study the diagnostic accuracy of MR Sialography in assessment of duct system in salivary gland diseases. This study was conducted on twenty patients. Magnetic Resonance imaging of the major salivary glands using conventional T1 and T2 weighted sequences, with addition of a heavily T2 weighted RARE [Rapid Acquisition with Relaxation Enhancement] MR sialography sequence was performed for all patients supplemented by conventional sialography and plain x-ray examination of the salivary glands. This study included twenty patients of different ages of both sexes, their ages were ranging from 4-80 years, complaining of pain and swelling at the regions of the salivary glands There were six neoplastic lesions, six inflammatory lesions, six sialolithiasis with and without associated sialadenitis, and two cases of non-neoplastic non-inflammatory lesions [sialosis]. Heavily T2-weighted MR sialographic imaging was able to delineate ductal anatomy and pathological changes as dilatation and displacement of the duct system of the examined major salivary glands in all cases. Combining such sialographic sequence with conventional MR sequences [T1 W and T2 W images] promise to be an ideal apprehensive imaging modality for evaluation of major salivary glands diseases
Subject(s)
Humans , Male , Female , Magnetic Resonance Imaging/methods , Sialography/methodsABSTRACT
Realiza mediante, la recopilación de estudios efectuados por diferentes autores, las patologías obstructivas que ocurren en las glándulas salivales; su etiología, evaluación y tratamiento de las mismas
Subject(s)
Salivary Glands/anatomy & histology , Salivary Glands/pathology , Sialography/methodsABSTRACT
Estudia la sialografia, como uno de los métodos paraclínicos utilizados en el diagnóstico de algunas patologías de glandulas salivales tales como: neoplasias, inflamaciones, quistes, malformaciones congénitas, traumatismos, enfermedades inmunológicas y metabólicos