The value of magnetic resonance sialography and magnetic resonance imaging versus conventional sialography of the parotid gland in the diagnosis and staging of Sjögren's syndrome

Nashwa S. Ahmed, Soad M. Mansour, Mohamed M. El-Wakd, Hatem M. Al-Azizi, Noha S. Abu-Taleb

Research output: Contribution to journalArticleResearchpeer-review

3 Citations (Scopus)

Abstract

Introduction: The conventional sialography (CS) and minor salivary gland biopsy have been considered the cornerstones of the diagnosis of Sjögren's syndrome (SS). However, they are invasive and with risk of complications to the patient. Magnetic resonance imaging (MRI) has been widely replacing conventional invasive examinations. They provide insufficient data for diagnosing and staging SS, because while they address the detection and diagnosis of parenchymal salivary gland disease they do not assess duct abnormalities. The introduction of magnetic resonance sialography (MRS) protocol was the first step towards non-ionizing non-invasive technique enables a more accurate assessment of the duct system. Moreover, it is postulated that the combined use of MRI and MRS is useful for the assessment of damaged salivary glands in SS. Aim of work: This preliminary study aimed to assess the role and efficacy of MRS and MRI in imaging the parotid gland in SS patients' and to compare their results with that of CS in the diagnosis and staging of SS. Patients and methods: The parotid gland was examined by MRS, MRI and CS in 15 SS patients. Scoring system for overall branching pattern, ductal system staging, sialectasis for both CS and MRS was used. MRI scoring system for glandular parenchymal pattern, size and contour and lymph node was used. Results: This revealed non-significant difference between CS and MRS findings in the diagnosis and staging of SS. Furthermore, no statistically significant correlation was found between the clinical and SS stage in both CS and MRS. On the other hand, a statistically significant positive correlation was found between the clinical findings and the MRI parenchymal stages. Moreover, MRS showed higher sensitivity and diagnostic accuracy values than CS. Combining the MRS and MRI abnormalities, 100% sensitivity diagnostic accuracy values were achieved in the diagnosis and staging of SS. The inter-observer agreement was higher in MRS than in CS and was perfect in MRI. Conclusion: In this preliminary study, MRS showed a higher sensitivity and accuracy in diagnosing and staging SS and may safely and securely replace CS. MRI and MRS give information on different aspects of glandular and duct pathology; therefore, both should be performed when examining the parotid glands in SS patients.

Original languageEnglish
Pages (from-to)147-154
Number of pages8
JournalEgyptian Rheumatologist
Volume33
Issue number3
DOIs
Publication statusPublished - 1 Jul 2011

Fingerprint

Sialography
Parotid Gland
Magnetic Resonance Spectroscopy
Magnetic Resonance Imaging

Keywords

  • Conventional sialography
  • Magnetic resonance imaging
  • Magnetic resonance sialography
  • Parotid gland
  • Sjögren's syndrome

Cite this

@article{23da024f35bf4769bffc98ee85a91660,
title = "The value of magnetic resonance sialography and magnetic resonance imaging versus conventional sialography of the parotid gland in the diagnosis and staging of Sj{\"o}gren's syndrome",
abstract = "Introduction: The conventional sialography (CS) and minor salivary gland biopsy have been considered the cornerstones of the diagnosis of Sj{\"o}gren's syndrome (SS). However, they are invasive and with risk of complications to the patient. Magnetic resonance imaging (MRI) has been widely replacing conventional invasive examinations. They provide insufficient data for diagnosing and staging SS, because while they address the detection and diagnosis of parenchymal salivary gland disease they do not assess duct abnormalities. The introduction of magnetic resonance sialography (MRS) protocol was the first step towards non-ionizing non-invasive technique enables a more accurate assessment of the duct system. Moreover, it is postulated that the combined use of MRI and MRS is useful for the assessment of damaged salivary glands in SS. Aim of work: This preliminary study aimed to assess the role and efficacy of MRS and MRI in imaging the parotid gland in SS patients' and to compare their results with that of CS in the diagnosis and staging of SS. Patients and methods: The parotid gland was examined by MRS, MRI and CS in 15 SS patients. Scoring system for overall branching pattern, ductal system staging, sialectasis for both CS and MRS was used. MRI scoring system for glandular parenchymal pattern, size and contour and lymph node was used. Results: This revealed non-significant difference between CS and MRS findings in the diagnosis and staging of SS. Furthermore, no statistically significant correlation was found between the clinical and SS stage in both CS and MRS. On the other hand, a statistically significant positive correlation was found between the clinical findings and the MRI parenchymal stages. Moreover, MRS showed higher sensitivity and diagnostic accuracy values than CS. Combining the MRS and MRI abnormalities, 100{\%} sensitivity diagnostic accuracy values were achieved in the diagnosis and staging of SS. The inter-observer agreement was higher in MRS than in CS and was perfect in MRI. Conclusion: In this preliminary study, MRS showed a higher sensitivity and accuracy in diagnosing and staging SS and may safely and securely replace CS. MRI and MRS give information on different aspects of glandular and duct pathology; therefore, both should be performed when examining the parotid glands in SS patients.",
keywords = "Conventional sialography, Magnetic resonance imaging, Magnetic resonance sialography, Parotid gland, Sj{\"o}gren's syndrome",
author = "Ahmed, {Nashwa S.} and Mansour, {Soad M.} and El-Wakd, {Mohamed M.} and Al-Azizi, {Hatem M.} and Abu-Taleb, {Noha S.}",
year = "2011",
month = "7",
day = "1",
doi = "10.1016/j.ejr.2011.05.004",
language = "English",
volume = "33",
pages = "147--154",
journal = "Egyptian Rheumatologist",
issn = "1110-1164",
publisher = "The Egyptian Society for Joint Diseases and Arthritis",
number = "3",

}

The value of magnetic resonance sialography and magnetic resonance imaging versus conventional sialography of the parotid gland in the diagnosis and staging of Sjögren's syndrome. / Ahmed, Nashwa S.; Mansour, Soad M.; El-Wakd, Mohamed M.; Al-Azizi, Hatem M.; Abu-Taleb, Noha S.

In: Egyptian Rheumatologist, Vol. 33, No. 3, 01.07.2011, p. 147-154.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The value of magnetic resonance sialography and magnetic resonance imaging versus conventional sialography of the parotid gland in the diagnosis and staging of Sjögren's syndrome

AU - Ahmed, Nashwa S.

AU - Mansour, Soad M.

AU - El-Wakd, Mohamed M.

AU - Al-Azizi, Hatem M.

AU - Abu-Taleb, Noha S.

PY - 2011/7/1

Y1 - 2011/7/1

N2 - Introduction: The conventional sialography (CS) and minor salivary gland biopsy have been considered the cornerstones of the diagnosis of Sjögren's syndrome (SS). However, they are invasive and with risk of complications to the patient. Magnetic resonance imaging (MRI) has been widely replacing conventional invasive examinations. They provide insufficient data for diagnosing and staging SS, because while they address the detection and diagnosis of parenchymal salivary gland disease they do not assess duct abnormalities. The introduction of magnetic resonance sialography (MRS) protocol was the first step towards non-ionizing non-invasive technique enables a more accurate assessment of the duct system. Moreover, it is postulated that the combined use of MRI and MRS is useful for the assessment of damaged salivary glands in SS. Aim of work: This preliminary study aimed to assess the role and efficacy of MRS and MRI in imaging the parotid gland in SS patients' and to compare their results with that of CS in the diagnosis and staging of SS. Patients and methods: The parotid gland was examined by MRS, MRI and CS in 15 SS patients. Scoring system for overall branching pattern, ductal system staging, sialectasis for both CS and MRS was used. MRI scoring system for glandular parenchymal pattern, size and contour and lymph node was used. Results: This revealed non-significant difference between CS and MRS findings in the diagnosis and staging of SS. Furthermore, no statistically significant correlation was found between the clinical and SS stage in both CS and MRS. On the other hand, a statistically significant positive correlation was found between the clinical findings and the MRI parenchymal stages. Moreover, MRS showed higher sensitivity and diagnostic accuracy values than CS. Combining the MRS and MRI abnormalities, 100% sensitivity diagnostic accuracy values were achieved in the diagnosis and staging of SS. The inter-observer agreement was higher in MRS than in CS and was perfect in MRI. Conclusion: In this preliminary study, MRS showed a higher sensitivity and accuracy in diagnosing and staging SS and may safely and securely replace CS. MRI and MRS give information on different aspects of glandular and duct pathology; therefore, both should be performed when examining the parotid glands in SS patients.

AB - Introduction: The conventional sialography (CS) and minor salivary gland biopsy have been considered the cornerstones of the diagnosis of Sjögren's syndrome (SS). However, they are invasive and with risk of complications to the patient. Magnetic resonance imaging (MRI) has been widely replacing conventional invasive examinations. They provide insufficient data for diagnosing and staging SS, because while they address the detection and diagnosis of parenchymal salivary gland disease they do not assess duct abnormalities. The introduction of magnetic resonance sialography (MRS) protocol was the first step towards non-ionizing non-invasive technique enables a more accurate assessment of the duct system. Moreover, it is postulated that the combined use of MRI and MRS is useful for the assessment of damaged salivary glands in SS. Aim of work: This preliminary study aimed to assess the role and efficacy of MRS and MRI in imaging the parotid gland in SS patients' and to compare their results with that of CS in the diagnosis and staging of SS. Patients and methods: The parotid gland was examined by MRS, MRI and CS in 15 SS patients. Scoring system for overall branching pattern, ductal system staging, sialectasis for both CS and MRS was used. MRI scoring system for glandular parenchymal pattern, size and contour and lymph node was used. Results: This revealed non-significant difference between CS and MRS findings in the diagnosis and staging of SS. Furthermore, no statistically significant correlation was found between the clinical and SS stage in both CS and MRS. On the other hand, a statistically significant positive correlation was found between the clinical findings and the MRI parenchymal stages. Moreover, MRS showed higher sensitivity and diagnostic accuracy values than CS. Combining the MRS and MRI abnormalities, 100% sensitivity diagnostic accuracy values were achieved in the diagnosis and staging of SS. The inter-observer agreement was higher in MRS than in CS and was perfect in MRI. Conclusion: In this preliminary study, MRS showed a higher sensitivity and accuracy in diagnosing and staging SS and may safely and securely replace CS. MRI and MRS give information on different aspects of glandular and duct pathology; therefore, both should be performed when examining the parotid glands in SS patients.

KW - Conventional sialography

KW - Magnetic resonance imaging

KW - Magnetic resonance sialography

KW - Parotid gland

KW - Sjögren's syndrome

UR - http://www.scopus.com/inward/record.url?scp=84880395988&partnerID=8YFLogxK

U2 - 10.1016/j.ejr.2011.05.004

DO - 10.1016/j.ejr.2011.05.004

M3 - Article

VL - 33

SP - 147

EP - 154

JO - Egyptian Rheumatologist

JF - Egyptian Rheumatologist

SN - 1110-1164

IS - 3

ER -