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Congress: ECR25
Poster Number: C-19806
Type: Poster: EPOS Radiologist (educational)
Authorblock: O. Meadows, A. Leontaritis, M. Persad, A. Weller, L. A. Ratnam; London/UK
Disclosures:
Olutobi Meadows: Nothing to disclose
Alexandros Leontaritis: Nothing to disclose
Melissa Persad: Nothing to disclose
Alex Weller: Nothing to disclose
Lakshmi A Ratnam: Nothing to disclose
Keywords: Head and neck, Salivary glands, Cone beam CT, Fluoroscopy, MR, Comparative studies, Diagnostic procedure, Sialography, Calcifications / Calculi, Dilatation, Dosimetric comparison
Learning objectives Examine the strengths and limitations of fluoroscopy, cone-beam CT (CBCT), and MRI in assessing salivary gland pathology. Provide an overview of the diagnostic capabilities and clinical applications of each imaging modality. Compare the radiation dose of CBCT with fluoroscopic sialography.
Read more Background Imaging plays a central role in the diagnosis, ductal mapping, and interventional planning/management of salivary gland disorders. These disorders include infections, salivary duct stones (sialolithiasis), tumours (benign or malignant), and inflammation (sialadenitis).For ductal pathology fluoroscopic sialography has long been considered the gold standard [1]. It provides dynamic, real-time visualisation of the salivary ductal system, allowing assessment of strictures, obstructions, and dilatation (sialectasis) with high spatial resolution. Fluoroscopic sialography also offers functional insights into salivary flow and ductal morphology. It is...
Read more Findings and procedure details FluoroscopyFluoroscopic sialography requires cannulation of the main parotid or submandibular duct. Retrograde opacification of the ductal system is achieved by injecting a water-soluble iodinated contrast medium under fluoroscopic imaging, with or without digital subtraction.Several potential challenges exist. Some patients may be difficult to cannulate – influencing factors include operator skill and experience, patient tolerance, and anatomical variations or underlying pathology (e.g. stenoses).When successfully performed, fluoroscopic sialography provides excellent spatial resolution and allows for precise localisation of stones, strictures, and sialectasis...
Read more Conclusion Each imaging modality has distinct advantages and limitations: Fluoroscopic sialography remains widely considered the gold standard for real-time evaluation of salivary ductal systems, particularly for diagnosing obstructions and sialolithiasis. However, its invasive nature and ionising radiation exposure are notable drawbacks. CBCT sialography reduces radiation exposure compared to fluoroscopy while offering enhanced spatial resolution and 3D imaging. It may serve as an alternative in cases where dynamic imaging or immediate therapeutic intervention is not required. MRI is the modality of choice for evaluating tumours,...
Read more References Rastogi R, Bhargava S, Mallarajapatna GJ, Singh SK. Pictorial essay: Salivary gland imaging. Indian J Radiol Imaging. 2012 Oct;22(4):325-33. Jager, L., Menauer, F., Holzknecht, N., Scholtz, V., Grevers, G., & Reiser, M. (2012). Sialolithiasis: MR sialography of the submandibular duct—an alternative to conventional sialography and US? Radiology, 223(2), 375-380. Gupta, A., Karjodkar, F., & Bhattacharyya, A. (2013). Conventional and digital sialography: A comparative study. Journal of Clinical and Diagnostic Research, 7(5), 925-930. Patel, N. A., Van Zante, A., Hovis, K., & Hatcher, D....
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