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(Radiology. 2000;216:665-671.)
© RSNA, 2000

Head and Neck Imaging

Sialolithiasis: MR Sialography of the Submandibular Duct-An Alternative to Conventional Sialography and US?1

Lorenz Jäger, MD, Frank Menauer, MD, Nikolaus Holzknecht, MD, Verena Scholz, MD, Gerhard Grevers, MD and Maximilian Reiser, MD

1 From the Institute of Diagnostic Radiology (L.J., N.H., V.S., M.R.) and the Department of Otorhinolaryngology (F.M., G.G.), Klinikum Grosshadern, Ludwig Maximilians Universität, Marchioninistrasse 15, 81366 Munich, Germany. Received September 28, 1999; revision requested November 1; revision received February 15, 2000; accepted February 22. Address correspondence to L.J. (e-mail: jaeger@ikra.med.uni-muenchen.de).

PURPOSE: To determine the value of magnetic resonance (MR) sialography for the diagnosis of sialolithiasis by comparing results prospectively with those of ultrasonography (US) and digital sialography.

MATERIALS AND METHODS: MR sialography was prospectively performed with T2-weighted three-dimensional (3D) constructive interference in steady-state (CISS) and rapid acquisition with relaxation-enhancement (RARE) sequences in 24 patients suspected of having sialolithiasis. Evoked salivation was used as contrast material. T1-weighted spin-echo and T2-weighted turbo spin-echo MR imaging also were performed. The results were then compared with those of US and digital sialography, with the latter as standard of reference.

RESULTS: The 3D CISS images were significantly (P < .05) superior to RARE images for demonstrating the submandibular ductal system, followed by T2-weighted turbo spin-echo images (P < .01) and T1-weighted spin-echo images (P < .001). The sensitivity and specificity were 100% and 80%, respectively, for CISS MR sialography and 80% and 100%, respectively, for RARE MR imaging. The sensitivity and specificity of US were both 80%.

CONCLUSION: MR sialography with evoked salivation is noninvasive and allows delineation of the submandibular ductal system and detection of sialoliths with accuracy that is similar to that of digital sialography and superior to that of US.

Index terms: Magnetic resonance (MR), comparative studies • Salivary glands, diseases, 2642.818 • Salivary glands, MR, 2642.121411, 2642.121412 • Salivary glands, radiography, 2642.1215 • Salivary glands, US, 2642.12981 • Ultrasound (US), comparative studies




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