Sialographic examinations with the digital subtraction technique were performed in 107 salivary glands (90 parotid and 17 submandibular) of 99 patients. Diagnostic and technical advantages of the digital imaging and subtraction for sialography were investigated. Superior quality enabled detailed imaging of the entire ductal system. Reduced radiation exposure, short examination time and almost painless examinations with good patient tolerance proved to be the major advantages of digital subtraction sialography as a diagnostic tool.
[Show abstract][Hide abstract] ABSTRACT: The management of patients undergoing 50 surgical procedures to the parotid gland was reviewed. The overall accuracy of fine needle aspiration cytology was 87%, false-positive and false-negative rates for malignant disease both being 4%. The sensitivity, specificity and accuracy of fine needle cytology for malignant parotid tumours was 66%, 95%, and 91%, respectively, that of benign tumours (pleomorphic adenoma or Warthin's tumour) being 88%, 83% and 87%, respectively. Sensitivity, specificity and accuracy for the remaining (principally inflammatory) parotid diseases was 100%, 95% and 96%, respectively. The predictive value of a positive test for malignant tumours, benign tumours and inflammatory conditions was 66%, 94% and 75%, respectively. The negative predictive value for these conditions was 95%, 71% and 100%, respectively. Facial nerve weakness after parotidectomy occurred in three patients (8.8%), being permanent in two cases (both malignant). Although Frey's syndrome was not recorded in any of the notes, careful follow-up revealed two cases (6%). To date there have been no local recurrences after excision of either benign or primary malignant parotid masses. One patient with squamous cell carcinoma metastatic to the parotid gland died, despite block dissection of the neck and radiotherapy. This small series with a limited follow-up suggests that diseases of the parotid gland can be managed by general surgeons with an interest in this field. Although fine needle aspiration and ultrasonic scan may be helpful, the decision to operate should be made on clinical grounds.
Annals of The Royal College of Surgeons of England 06/1995; 77(3):188-92. · 1.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The study included patients in whom digital subtraction sialography was performed in the diagnosis of sialolithiasis, chronic and chronicrecurrent inflammations, and other pathological conditions of the salivary glands. A group of 42 patients was examined, consisting of 6 women and 36 men with signs of chronic inflammatory processes, suspected sialolithiasis, dislocation of the duct and Sjögren’s syndrome. The method of digital subtraction sialography provides excellent presentation of the secretory canal of the salivary gland and small intraductal canals up to the glandular parenchyma. The method enables excellent vision of alterations within the parenchyma, changes which have an effect on the lumen and position of the canal, and eventual changes which are conditioned by external factors. The smallest canal structures are also shown by this method. Thus, the possibility of an erroneous finding, which frequently occurs with other diagnostic methods, is significantly reduced.
[Show abstract][Hide abstract] ABSTRACT: To compare the visualization of salivary ducts by ultrafast magnetic resonance sialography (MR sialography) using an alternative surface coil and a conventional head-neck coil.
In 11 healthy volunteers, ultrafast MR sialography (single shot turbo spin echo; acquisition time, 2.8 s) was performed before and after oral application of a sialogogue. Each subject received examinations with both a bilateral surface coil (SC) and a conventional head-neck coil (HNC). The depiction of parotideal and submandibular duct systems was graded from 1 to 5 (5 = poor) by four independent radiologists. ANOVA served for statistical analysis of duct rankings, and interobserver variability was determined by Intraclass Correlation Coefficient (ICC).
With an excellent ICC of 0.96, both coil systems offered symmetric visualization of salivary ducts, and the image quality increased after oral application of sialogogue (p < 0.001). In total, the overall rating was worse for SC than for HNC (2.13 +/- 1.24 vs. 1.45 +/- 0.65, p < 0.001). SC was especially inferior in depiction of submandibular and extraglandular duct components compared to HNC (p < 0.001).
Most notably due to the reduced visualization of extraglandular and submandibular ducts, the specific surface coil used in this study was inferior in image quality and does not constitute a reasonable alternative to conventional coil systems.
RöFo - Fortschritte auf dem Gebiet der R 10/2008; 180(11):977-82. DOI:10.1055/s-2008-1027671 · 1.40 Impact Factor
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