ABSTRACT
OBJECTIVE: To compare the accuracy of ultrasound, sialography, and sialendoscopy for examining benign salivary gland obstructions. METHODS: In this prospective study, patients with symptoms of obstruction of the major salivary gland duct system presenting at the ENT Clinic University Hospital, Ostrava, from June 2010 to December 2013 were included. All patients (n=76) underwent ultrasound, sialography, and sialoendoscopy. The signs of sialolithiasis, ductal stenosis, or normal findings were recorded after the examinations. Statistical analysis of the sensitivity and specificity of all the methods was performed, as well as a comparison of the accuracy of each method for different kinds of pathology (sialolithiasis or stenosis). RESULTS: The sensitivity of ultrasound, sialography, and sialoendoscopy for sialolithiasis findings were 71.9%, 86.7 %, and 100%, respectively. The sensitivity of sialography and sialoendoscopy for stenosis of the duct was 69.0%, and 100%, respectively. The study showed impossibility of ultrasonic diagnostics of ductal stenosis. The sensitivity of sialoendoscopy for both pathologies was significantly higher than that from ultrasound or sialography (p<0.05). The specificity of sialoendoscopy was significantly higher than that from by ultrasound or sialography (p<0.05). CONCLUSION: Sialoendoscopy was the most accurate method for examination ductal pathology, with significantly higher sensitivity and specificity than by ultrasound or sialography.
ABSTRACT
OBJECTIVES: The aim of the study was to assess the use of color Doppler ultrasound in the pre-histological determination of the biological features of salivary gland tumors. MATERIAL AND METHODS: Ninety-six patients with major salivary gland tumors of unknown histology were examined and operated on in our clinics. They were pre-operatively examined using ultrasound imaging with color Doppler. Peak systolic velocity (PSV) was measured and pulsatility index (PI) and resistive index (RI) were calculated on the pulsed wave traces. The Doppler flow parameters were correlated with clinical stage and tumour type (benign/carcinoma) as confirmed by final histological diagnosis. For the correlations, the tumors were categorized into 3: benign (group I), malignant stages I+II (group II), malignant stages III+IV (group III). RESULTS: The average PSV value was 22.15 cm/s for benign and 32.74 cm/s for all malignant tumors. The average RI value was 0.77 for benign and 0.86 for all malignant tumors. The average PI value for benign tumors was 2.85 and 3.14 for all malignant tumors. No significant differences between benign and malignant tumors in terms of SV and PI values were found. The RI values for benign tumors differed significantly from those of malignant ones (P=0.021). There were no significant differences in average PSV, PI and RI values in relation to salivary gland tumor group - I, II, III. There was no confirmation of the reported applicability of PSV and PI values in differenting benign from malignant tumors. CONCLUSION: We were not able to demonstrate significant differences in Doppler flow parameters PSV and PI between benign tumors and carcinomas. Only the RI could be used to differentiate them. There were also no significant differences in PSV, PI and RI values between low (I+II) and high (III+IV) clinical tumour stage.
