PURPOSE: The purpose of this study was to evaluate the effectiveness o
f MR sialography of the parotid gland ducts in the diagnosis and stagi
ng of Sjogren syndrome. METHODS: MR imaging was performed on a 1.5-T u
nit with a neck phased-array coil. MR sialographic source images were
obtained using a heavily T2-weighted fast spin-echo sequence with spec
tral fat suppression. All images were analyzed on the basis of maximum
intensity projection reconstruction. Five healthy control subjects an
d 51 patients with definite Sjogren syndrome (43 with primary disease
and eight with secondary disease) were examined with MR sialography, A
labial gland biopsy was performed in all patients and histopathologic
grading was done by means of focal scores. The findings of MR sialogr
aphy were compared with the results of labial gland biopsy to determin
e the effectiveness of the technique in the diagnosis and staging of S
jogren syndrome. RESULTS: In all five control subjects, the main duct
and the primary branching ducts of the parotid glands were clearly vis
ible on MR sialographic images. In patients with Sjogren syndrome, a p
unctate, globular, cavitary, or destructive appearance was well seen w
ithin the parotid glands. Findings obtained at MR sialography correlat
ed well with the results of labial gland biopsy. CONCLUSION: MR sialog
raphy has the potential to produce diagnostic findings in the parotid
gland ducts of patients with Sjogren syndrome. Our results suggest tha
t this method will augment and possibly replace X-ray sialography.