背景:唾液导管系统的成像在内窥镜或外科手术之前是相关的。各种成像模态可以用于此目的。这项研究的目的是比较三维(3D)锥形束计算机断层扫描(CBCT)唾液造影与磁共振(MR)唾液造影在非肿瘤性唾液病理学中的诊断能力。
方法:这种前瞻性,单中心,初步研究比较了46例患者(平均年龄50.1±14.9岁)唾液症状的两种影像学检查方法.分析是由两名独立的放射科医生进行的,涉及唾液疾病的鉴定,包括唾液酸结石。狭窄,或扩张(主要终点)。异常的位置和大小,可以可视化的唾液导管的最后一个分支,潜在的并发症,并收集暴露参数(次要终点)。
结果:唾液症状涉及颌下腺(60.9%)和腮腺(39.1%)。唾液管结石,扩张,在24、25和9例患者中观察到狭窄,分别,在病变识别方面,两种成像方式之间没有观察到统计学差异(分别为p1=0.66,p2=0.63和p3=0.24)。观察者之间的一致性对于病变识别是完美的(>0.90)。MR唾液造影在唾液结石和扩张的可视化方面优于3D-CBCT唾液造影,如0.90[95%CI0.70-0.98]与较高的正百分比一致性(敏感度)所证明的那样0.82[95%CI0.61-0.93],和0.84[95%CI0.62-0.94]与0.70[95%CI0.49-0.84],分别。为了识别狭窄,两种手术均获得了相同的低阳性百分比一致性(0.20[95%CI0.01-0.62]).石头的位置具有良好的一致性(Kappa系数为0.62)。通过3D-CBCT唾液造影观察到两名患者的导管插入失败。
结论:这两种成像程序都是非肿瘤性唾液病理学诊断库的一部分。然而,MR唾液造影可能比3D-CBCT唾液造影更有效地识别胆管结石和导管扩张。
背景:NCT02883140。
Imaging of the salivary ductal system is relevant prior to an endoscopic or a surgical procedure. Various imaging modalities can be used for this purpose. The aim of this
study was to compare the diagnostic capability of three-dimensional (3D)-cone-beam computed tomography (CBCT) sialography versus magnetic resonance (MR) sialography in non-tumorous salivary pathologies.
This prospective, monocenter, pilot
study compared both imaging modalities in 46 patients (mean age 50.1 ± 14.9 years) referred for salivary symptoms. The analyses were performed by two independent radiologists and referred to identification of a salivary disease including sialolithiasis, stenosis, or dilatation (primary endpoint). The location and size of an abnormality, the last branch of division of the salivary duct that can be visualized, potential complications, and exposure parameters were also collected (secondary endpoints).
Salivary symptoms involved both the submandibular (60.9%) and parotid (39.1%) glands. Sialolithiasis, dilatations, and stenosis were observed in 24, 25, and 9 patients, respectively, with no statistical differences observed between the two imaging modalities in terms of lesion identification (p1 = 0.66, p2 = 0.63, and p3 = 0.24, respectively). The inter-observer agreement was perfect (> 0.90) for lesion identification. MR sialography outperformed 3D-CBCT sialography for visualization of salivary stones and dilatations, as evidenced by higher positive percent agreement (sensitivity) of 0.90 [95% CI 0.70-0.98] vs. 0.82 [95% CI 0.61-0.93], and 0.84 [95% CI 0.62-0.94] vs. 0.70 [95% CI 0.49-0.84], respectively. For the identification of stenosis, the same low positive percent agreement was obtained with both procedures (0.20 [95% CI 0.01-0.62]). There was a good concordance for the location of a stone (Kappa coefficient of 0.62). Catheterization failure was observed in two patients by 3D-CBCT sialography.
Both imaging procedures warrant being part of the diagnostic arsenal of non-tumorous salivary pathologies. However, MR sialography may be more effective than 3D-CBCT sialography for the identification of sialolithiasis and ductal dilatations.
NCT02883140.