Learning objectives
With thisposter,
the authors intended toanalyze theexperienceof the Radiology departmentof Oporto Hospital Centre,
during a period of three and half years,
in the performance of conventional sialography.
We also present a review of the pathologic findings and a presentation of the performed technique.
Background
Sialography is one of the oldest imaging procedures and was first mentioned by Carpy in 1902.
In 1925,
Barsony and Uslenghi separately described sialography as a diagnostic tool.
Theradiographicsialographyallowsthe demonstrationof the ducts,ductulesand parenchymaof the salivary glandsby introducingafat-soluble radiopaque contrastin theirexcretory ducts.
With thismethod we onlyaccess themajorsalivaryglandssuch asparotidand submandibular.The sublingual gland,despite beingamajorgland,
hasadifficult cannulationand thereforethis techniqueis not routinely performed.
Sialographyremains the"standard"imaging technique for the studyofextra andintraglandularductal system.Its highspatial resolutionallowsadetailed viewof the glandular ductandexcretorytreewithparenchymalductal branchingup to 4th order,
enabling the identification ofsubtlepathological changes inthe level of thesestructures....
Imaging findings OR Procedure details
Procedure description
Before startingthe procedure: any removable dental work,
jewelry,
and other artifact causing opaque items must be removed ; an overhead lamp is used to provide adequate light.
Gather thenecessarytools and materials such as metallic dilator,plasticcannula,
contrast media (Lipiodol®),
gauze,
syringes and a lemon;
PreliminaryX-rays are obtained; Fig. 1
The duct is cannulated,
not punctured,
and contrast is introduced with fluoroscopic guidance; Fig. 2
Radiographsare obtainedduring thefillingof the treesalivating(main duct,
several ductulesandglandular parenchyma); Fig. 3
After the radiographs,
the patient then sucks on a...
Conclusion
Despite being an invasive technique and the exposure toradiation,syalography is an accessible and economic technique.
It still holdsasignificant importance for thediagnosis andtreatment planningof pathologiesthat oftenaffect the salivary glandsincludingchronic sialoadenitisandsialolithiasis,without recoursetosupplementary means ofdiagnosis with higher resolution.
Complicationsof the procedureare uncommonespecially ifthe right technical stepsare followed.
Personal Information
S.
Magalhães,
I.
Ferreira,
AB Ramos,
F.
Reis.OPORTO´S HOSPITALAR CENTRE- Prof Abel Salazar square,
4099-001PORTO.
Telephone number: 222077500.
Fax : 223320318.
Email to:
[email protected]
References
Jäger,
L.,
Menauer,
F.,
Scholz,
V.,Reiser,
M.: Sialolithiasis: MR sialography of the submandibular duct - an alternative to convencional sialography and US.
Radiology,
216:665-671,
September 2000;
Kalinowski,
M.,
Rehberg,
E.,Klose,
K.,
Wagner,
H.: Comparative study of MR sialography and digital subtraction sialography for benign salivary disorders.
AJNR,
23:1485-1492,
October 2002.
Rabinov,
K.,
Weber,
A.: Radiology of salivary glands.
GK Medical Publishers 1985.
