Assessment of salivary glands' structure and function using CBCT sialography

Objectives: Sialography is a well-established tool for salivary glands imaging. In the last few years cone-beam computerized tomography sialography (sialo-CBCT) was introduced allowing three dimensional assessment of the salivary glands. This research aimed to characterize patients with major salivary glands pathologies referred to sialo-CBCT and to establish their imaging radiographic features
Methods: This retrospective study examined patients' data, over a period of one year, referred to sialo-CBCT in the Oral Maxillofacial Radiology Unit in the Department of Oral Medicine. Demographic data, medical history and clinical symptoms were collected. Thereafter, the imaging data of each sialo-CBCT was analyzed by two examiners for different radiographic characterization. These included: the presence of an accessory gland, kinks, dilatations, constrictions, filling defects, number of splits, boundaries, ductophillia and ductopenia and the presence of sialectasias. Statistical analysis compared the radiographic characteristics for each gland and for each referral reason.
Results: Data from 97 patients referred to sialo-CBCT were examined. Patient’s age ranged between 18 to 86 years old (54.4±13.97), two third of which were females, who mostly complained of dry mouth. Most referrals were from oral medicine specialists followed by oral surgeons. Most sialo-CBCT examinations were done to the parotid glands. Low kappa levels were found between the two observers for most of the radiologic characteristics. The radiologic diagnosis of patients referred for parotid CBCT-sialography varied between normal, chronic obstructive sialadenitis and Sjogren’s syndrome related sialadenitis. In comparison, the majority of patients referred for submandibular CBCT- sialorgraphy were diagnosed with chronic obstructive sialadenitis.
Conclusions: The radiologic characteristics of CBCT-sialography are complex. Patients referred to parotid CBCT-sialography demonstrates mixed radiologic characteristics with a number of variations. Further computerized analysis is needed in order to fully exploit the information that could be obtained by this relatively new technique.