Diagnostic accuracy of MR sialography in sialolithiasis and salivary ductal stenosis

ObjectivesThe purpose of this study is to determine the diagnostic accuracy of MR sialography in the examination of patients with salivary duct disease.Patients and methodsTwenty-eight patients (twenty males and eight females, average age, 47 years), with symptoms related to the salivary glands, underwent both conventional sialography and MR sialography. The latter was performed using heavily T2-weighted, two dimensional, fast spin-echo techniques and a neck coil. Contiguous 3-mm axial images with frequency-selective fat suppression were acquired through the symptomatic gland. The MR sialography findings were compared with the final diagnoses determined by conventional sialography, and with surgery in the case of those who underwent surgical intervention. Ultrasound examination was performed using 7.5 MHz transducer. Conventional sialography was performed with the use of 0.012–0.021 inch sialographic catheter and an injection of 0.3–1.5 ml Ultravist 300 mg/ml.ResultsFinal diagnosis included sialolithiasis in eleven cases, sialolithiasis and stenosis in four cases, stenosis without lithiasis in ten cases and normal salivary glands in three cases. (The normal cases were excluded from the study).ConclusionIt is concluded that MR sialography with a heavily T2-weighted sequence is highly successful in the noninvasive visualization of the ductal system of major salivary glands in cases that could not be examined by conventional sialogram. It is useful for diagnosing sialolithiasis and ductal stenosis. However, normal MR sialographic findings do not allow the exclusion of small calculi. Thus in patients with strong clinical suspicion of calculi and normal MR sialographic findings, conventional sialography should still be performed.