A 50-year-old female was admitted to our department, complaining of progressive numbness of distal limbs for two years and unsteady gait for two months. “Peripheral neuropathy” was the presumed diagnosis. She has suffered dry mouth for months. Neurological examination revealed proximal upper muscle strength was normal and distal was 5-/5 while muscle strength in lower limbs was normal. Tendon reflexes in all limbs were reduced, and superficial sensation as well as deep sensation in all limbs was also diminished. Deep sensation below T 8-10 was diminished. Romberg’s test was positive with negative pathological reflex. Several sensory nerves action potentials (SNAPs) were diminished or absent with normal compound muscle action potentials (CMAPs). Cervical MRI showed hyperintensities in the dorsal column. Serum anti-Ro/SSA antibody was positive. Tear break-up time was abnormal in either eye (5s, normal range>10s); the rate of saliva production declined 0.02 ml/min (> 1.50 ml/15 min); parotid gland contrast sialography was abnormal; lip biopsy was positive with focal lymphocytic sialadenitis with focus score ≥1. The patient was diagnosed as primary Sjogren's syndrome and sensory neuronopathy. She received oral prednisone in dose of 1mg/(kg·d) for four weeks, then reduce the dosage with 5mg/w to 0.50mg/ (kg·d). Later she reduced the dosage with 2.5mg/per week. At the same time, she got cyclophosphamide (100mg every other day) and hydroxychloroquine (0.20g twice a day). Numbness of limbs and unsteady gait were improved when the patient was discharged. Two month later, during the follow-up, the patient’ gait was slightly improved, but the numbness still existed. DOI: 10.3969/j.issn.1672-6731.2016.11.016

Objective To investigate the feasibility of magnetic resonance sialography (MRS) in the evaluation of salivary gland function in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy. Methods The MRS images of parotid and submandibular glands were collected in resting and stimulated states among 32 patients with nasopharyngeal carcinoma before and after radiotherapy. The visibility of the salivary ducts and radiation-induced xerostomia were evaluated, and the relationship between radiation-induced acute xerostomia grade and MRS score was analyzed. Comparison of the visibility and score between two groups was made by paired t test, and the correlation between acute xerostomia grade and MRS score was determined using the Spearman rank correlation method. Results Both the visibility of salivary duct and MRS score were significantly reduced after radiotherapy (P=0.000, P=0.000). There were significant differences in the variation of MRS scores of the parotid (DPS) and submandibular glands (DSS) from the resting state to the stimulated state between patients with severe and non-severe acute xerostomia (P=0.009; P=0.005). There were no significant differences in MRS scores of the parotid and submandibular glands in resting and stimulated states between patients with severe and non-severe acute xerostomia (P=0.881, P=0.305, P=0.327, P=0.229). The Spearman correlation analysis showed that the acute xerostomia grade was negatively correlated with DPS and DSS (R=-0.472, P=0.006; R=-0.482, P=0.005). Conclusions MRS score is correlated with xerostomia grade. MRS can be used to evaluate the salivary gland function in patients with nasopharyngeal carcinoma treated with radiotherapy. Key words: Xerostomia; Magnetic resonance sialography; Salivary gland; Nasopharyngeal neoplasms/radiotherapy

Objective To investigate MR imaging features of parotid gland in Sj?gren′s syndrome ( SS).Methods Twenty-seven cases of xerostomia patients were collected and divided into SS group ( n=21) and non-SS group (n=6) according to the international classification (diagnosis) criteria for SS.Ten healthy volunteers were recruited as the control group.All the subjects underwent conventional MRI of parotid gland and MR sialography ( MRS).Standard deviation of T 1 WI and T2 WI signal intensity among 3 groups was observed, meanwhile, grading was made according to parotid glands , fat signal and parotid duct expansion degree respectively.With clinical diagnosis as the gold standard , diagnostic value of conventional MRI , MRS and their combination used in SS was compared.One-way ANOVA was used in comparison of standard deviation of parotid gland′s signal intensity among 3 groups , and Chi-square test was applied in comparison of conventional MRI and MRS diagnostic value.Moreover , Kappa value was calculated to assess the consistency of two grading results in SS.Results Signal intensity of parotid glands in control group and non-SS group was homogeneous.However , bilaterally diffused and heterogeneous high signal intensity on both T1WI and T2WI was found in SS patients, which was depressed on T2WI fat suppression sequences.Forty-two parotid glands were graded by fat signal:Grade 0 (n=2 glands), Grade 1 (n=10), Grade 2 (n=10), Grade 3 (n=6) and Grade 4 (n=14).Parotid peripheral ducts of control group and non-SS group were unexpanded , while bilaterally expanded parotid peripheral ducts were shown in SS patients.The grading of 42 parotid glands by expansion degree of parotid duct , Grade 0 was rated in 12, Grade 1 in 8, Grade 2 in 10, Grade 3 in 5, and Grade 4 in 7.Standard deviation of T1WI signal intensity of parotid glands among SS group , non-SS group and control group were 124.1 ±30.0, 81.8 ±27.6, and 86.3 ±35.0 respectively;and standard deviation of T 2 WI signal intensity were 115.1 ±35.2, 69.8 ±23.5, and 80.1 ±31.4 respectively; the standard deviation of T 1 WI and T2 WI signal intensity of SS group was higher than both non-SS group and control group′s ( F value =13.780 and 13.301, respectively, P 0.05).Among 42 parotid glands with SS, conventional MRI and MRS showed parotid gland lesions in 40 and 30 respectively , and the difference was statistically significant (χ2 =13.04, P=0.013).There was no false positive result.The combination of the two methods detected all 42 lesions.The consistency of detecting parotid abnormalities with SS between conventional MRI and MRS was poor (Kappa=0.12, P=0.092).Conclusions Diffuse fatty infiltration on conventional MRI and diffuse peripheral duct dilatation on MRS in the parotid gland are characteristic features of SS , and conventional MRI could be used as the preferred technique for the SS.combination with MRS may improve diagnostic accuracy. Key words: Sj?gren′s syndrome ; Parotid gland ; Magnetic resonance imaging ; Sialography ;

ABSTRACT: The Salivary stones and strictures are the most common cause of unilateral parotid or submandibular gland swelling. Traditionally, these patients treated by open surgery submandibular stones are still the most common cause of submandibular gland resection parotid gland resection is less frequent as it is major surgical procedure with postoperative complication like facial nerve paresis. The common cause of stone formation is obstruction, stricture formation leading to stasis of saliva, dehydration, change in salivary pH associated with oropharngeal sepsis. Over the last two decades, increasing awareness for minimally invasive treatment and with development of interventional radiological procedures for the management of obstructive sialadenitis has led to avoid surgical removal of gland and complications associated with surgery The interventional sialographic procedures can be used to remove salivary duct stones and is treatment of first choice in salivary duct strictures. For stone removal and stricture dilatation local anesthesia, I/V cannulas of different sizes, balloon dilators and wire baskets are used under fluoroscopy. The wire guided sialographic technique (1) is used for sialography and the I/V cannula used for sialography is used as access for interventional sialography. The stones in the intraglandular ducts, large stones and distal stones near the hilum of the gland are difficult to remove and the small size mobile stones can be easily removed. KEYWORDS: Salivary gland, Salivary stone, Salivary duct stricture, Salivary fistula, obstructive sialoadenitis, Interventional Sialography.

Assessment of salivary gland function plays an important role in the diagnosis and treatment of salivary gland disease.Currently,there are several ways to evaluate the salivary gland function including sialography,salivary gland flowmetry,radionuclide imaging,ultrasonography Doppler and MRI.The pros and cons of these different methods were reviewed and analysed.Nowadays,sialography and salivary gland flowmetry are less commonly used clinically.Doppler can be used for screening of salivary gland diseases.Radionuclide imaging is the clinically preferred method,and MRI is one of the most rapidly developing methods for the evaluation of salivary gland function.Proper selection of these methods can provide valuable information for the diagnosis and treatment of salivary gland diseases. Key words: Salivary glands ; Ultrasonography ; Radionuclide imaging; Magnetic resonance imaging; Trends

Objective To investigate the value of magnetic resonance sialography (MRS) as a noninvasive tool in evaluating major salivary gland function before and after radiotherapy (RT) for nasopharyngeal carcinoma patients.Methods From August 2009 to June 2010,patients with stage Ⅰ and Ⅱa (AJCC/UICC 2002) nasopharyngeal carcinoma were enrolled.All the patients were treated with intensity modulated radiation therapy alone.MRS with salivary stimulation was performed in patients before and after RT on a 3.0T MR scanner.An MRS categorical scoring system was used to compare the visibility of ducts pre-RT and post-RT.The relationship between MRS score and EORTC Core QOL and EORTC Head and Neck QOL was analyzed.Spearman rank correlation test was performed to analyze the non-stimulated and stimulated MRS findings and the clinical severity of xerostomia.Results All 10 enrolled patients completed planned treatment.The mean dose of the parotid glands and submandibular glands were (37.99 + 3.70) Gy and (55.65 + 2.99) Gy,respectively.Good-quality MRS images were obtained.The visibility scores of both the parotid and submandibular ducts were increased after secretion stimulation.Irradiation decreased the visualization of the salivary ducts and attenuated the response to secretion stimulation.There were specific correlations between post-RT secretion response of the parotid gland and EORTC QLQ scales ( global QOL scale in QLQ-C30 ( rs =0.636,P =0.048 ) and xerostomia scale in QLQ H&N35 ( rs =- 0.694,P =0.026) ).Conclusions MRS can be used as a non-invasive way to evaluated of the functional changes of major salivary glands before and after RT and as a promising approach for investigating radiation-induced xerostomia. Key words: Magnetic resonance sialography; Radiation-induced xerostomia; Nasopharyngeal neoplasms/radiotherapy

Ethiodol Extravasation during Sialography

Objective To study the diagnosis and treatment of trauma to parotid duct. Methods The clinical data of 17 patients were retrospectively reviewed. The patients' records were reviewed for gender, ages,mechanism of injury, location, clinical symptoms, assistant examination, therapy and prognosis. Results Aage prediction for 20-29 (represented 58.82% of the total cases); the most location of the trauma were in duct over masseter muscle; the injuries were usually caused by knives. Sialography can be used to diagnosed parotid duct injuries. Anastomosis of parotid duct can achieve good prognosis. Conclusion It may be possible to restore the function of parotid gland by timely diagnosis and proper treatment of trauma to parotid duct. Key words: Parotid gland; Parotid duct; Trauma; Sialography

18 Sialography: its diagnostic supremacy over ultrasound when treatment planning for stones and strictures

Juvenile recurrent parotitis.

Journal Article Sialography: Its technique and applications Get access Reginald T Payne Reginald T Payne Chief Assistant Surgical Unit, St. Bartholomew's Hospital, London Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 19, Issue 73, July 1931, Pages 142–148, https://doi.org/10.1002/bjs.1800197314 Published: 06 December 2005

Australasian RadiologyVolume 33, Issue 2 p. 171-172 A Helpful Sialography Technique VINCENT J. ACTON M.B.B.S., D.D.R., F.R.A.C.R., VINCENT J. ACTON M.B.B.S., D.D.R., F.R.A.C.R. 109 Lethbridge Street, Penrith 2750 Australia.Search for more papers by this author VINCENT J. ACTON M.B.B.S., D.D.R., F.R.A.C.R., VINCENT J. ACTON M.B.B.S., D.D.R., F.R.A.C.R. 109 Lethbridge Street, Penrith 2750 Australia.Search for more papers by this author First published: May 1989 https://doi.org/10.1111/j.1440-1673.1989.tb03265.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume33, Issue2May 1989Pages 171-172 RelatedInformation

Bacteraemia consequential to sialography.

HomeRadiologyVol. 141, No. 1 PreviousNext Improved instruments for sialography.K RabinovK RabinovK RabinovPublished Online:Oct 1 1981https://doi.org/10.1148/radiology.141.1.7291535MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Article HistoryPublished in print: 1981 FiguresReferencesRelatedDetailsCited ByThe salivary ducts of Wharton and Stenson: Analysis of normal variant sialographic morphometry and a historical reviewAvrilHorsburgh, Tarik F.Massoud2013 | Annals of Anatomy - Anatomischer Anzeiger, Vol. 195, No. 3Technical report: Wire guided sialographyM.O.Aslam, S.Hussain, I.Rizvi, W.Bley1991 | Clinical Radiology, Vol. 44, No. 5Recommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 141, No. 1 Metrics Altmetric Score PDF download

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Hydrostatic sialography: An analysis of a technique

Sialography in newborns and infants : J. Martinez-Mora, J. Boix-Ochoa, L. Treasserra, and J. M. Casasa. Ann. Chir. Inf. 13:69–78, 1972

The role of sialography in extraparotid disease

Sialography. New application of the subtraction technique.

Sialography in the Dog