Prospective comparison of magnetic resonance sialography and digital subtraction sialography

We sought to compare the diagnostic utility of magnetic resonance sialograp hy (MRS) and digital subtraction sialography (DSS) in patients with suspect ed sialolithiasis or sialadenitis, Sixteen consecutive patients (4 female a nd 12 male, mean age 51 +/- 16 years) with suspected sialolithiasis or sial adenitis underwent DSS by a standard technique and MRS. MRS was obtained wi th a T2-weighted single-shot TSE sequence (TR/TE 2800/1100 msec, acquisitio n time 7 seconds) using a quadrature head (n = 15) and a surface coil (n = 8), Nineteen symptomatic glands were investigated with DSS: eight submandib ular glands in 6 patients (two bilateral) and unilateral parotid glands in 11 patients. MRS was always carried out to visualize gland ducts bilaterall y, The ductal system was visualized in all glands examined by MRS. DSS depi cted the ductal system in all 11 parotid glands, but only 4 of the 8 subman dibular glands (50%), Sialolithiasis was diagnosed in three cases (one paro tid, two submandibular glands) by MRS and in two cases by DSS, DSS demonstr ated tertiary branching ducts and MRS secondary branching ducts, MRS is abl e to visualize the ductal system of the parotid and submandibular gland non invasively and is thus not dependent on successful cannulation of the orifi ce of the ductal system. Our preliminary data indicate that MRS is useful f or diagnosing sialolithiasis, MRS allows diagnosis of sialadenitic changes, but DSS achieves a better diagnostic performance due to higher spatial res olution. (C) 2000 Wiley-Liss, Inc.