A prospective comparative study of MR sialography and conventional sialography of salivary duct disease

OBJECTIVE. The purpose of this study was to determine the diagnostic accura cy of MR sialography in the examination of patients with salivary duct dise ase. SUBJECTS AND METHODS. Forty-nine patients (23 males and 26 females; 16-78 y ears old; mean age, 47 years) with symptoms related to the salivary glands underwent both conventional sialography and MR sialography. The latter was performed using a heavily T2-weighted, two dimensional, fast spin-echo tech nique and a 12-cm circular surface coil. Contiguous 3-mm axial images with frequency-selective fat suppression were acquired through the symptomatic g land. The MR sialography findings were compared with the final diagnoses de termined by conventional sialography. RESULTS. Conventional sialography showed calculus disease (n = 13), strictu re (n = 12), sialectasis (n = 4), cast (n = 3), neoplasm (n = 2), and norma l duct (n = 16). MR sialography alone had a sensitivity of 69% in revealing calculus disease. However, the sensitivity increased to 100% when MR sialo grams were combined with control radiographs. MR sialography was sufficient to accurately reveal stricture, sialectasis, and neoplasm and to direct th erapy on the basis of its findings. Overall, MR sialography combined with c ontrol radiographs had a sensitivity, specificity, and diagnostic accuracy of 100%, 88%, and 96%, respectively, in revealing salivary duct abnormaliti es. CONCLUSION. MR sialography alone is not sufficiently sensitive to reveal sa livary duct stones. Caution must be exercised when excluding calculus disea se. MR sialography, when combined with control radiographs, is accurate and has the potential to replace conventional sialography.