Magnetic resonance sialography using CISS and HASTE sequences in inflammatory salivary gland diseases: Comparison with digital sialography

Abstract

Inflammatory conditions are the most common pathology affecting the salivary glands. Magnetic resonance (MR) sialography has emerged as an alternative to conventional sialography for evaluation of inflammatory salivary gland diseases. To prospectively evaluate the role and diagnostic accuracy of MR sialography in the diagnosis of inflammatory salivary gland disease. Thirty-seven glands in 28 patients (19 males and nine females; mean age 31 years, range 3-65 years) presenting with inflammatory salivary gland disorders underwent MR sialography. Conventional sialography was used as the gold standard and was performed in 26 patients (34 glands). Thus, comparative evaluation was done in 26 patients (34 glands). Axial T1-weighted (T1W) and fat-suppressed T2W sequences, a constructive interference in steady state (CISS) sequence in the axial plane with maximum intensity projection (MIP)/multiplanar reformation (MPR) done in the axial and sagittal oblique planes, and a half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequence in the sagittal oblique direction were performed. Main salivary gland duct was visualized in 32 glands (94.1%) with MR sialography, and in all 34 (100%) glands with conventional sialography. Calculus and strictures were well demonstrated by MR sialography. MR sialography was superior for demonstration of the ductal system proximal to calculus/strictures. Sensitivity and specificity for diagnosis of specific pathology were 87% and 100% with CISS sequence and 90% and 75% with HASTE sequence, respectively. On using a combination of CISS and HASTE sequences, the sensitivity, specificity, and positive and negative predictive values in the diagnosis of specific pathology were 93%, 100%, 100%, and 64%, respectively. MR sialography using CISS and HASTE sequences is a promising technique and has the potential to replace conventional sialography in patients with inflammatory salivary gland disorders.