Is Sialography Effective in Diagnosing the Salivary Component of Sjögren's Syndrome?

Abstract

Parotid sialography has been used for many years as a means of assessing salivary glands in Sjogren's syndrome (SS), and it is occasionally used as a diagnostic criterion for the salivary component of SS. To assess its diagnostic effectiveness, we reviewed studies in which sialography was applied to patients with SS and control subjects for the purpose of estimating its diagnostic sensitivity and specificity or comparing it with other means of assessing salivary glands. Sialography appears to be diagnostically less sensitive but more specific than salivary flow rate measurement and more sensitive but less specific than labial salivary gland (LSG) biopsy. Such calculations are based on the diagnosis of SS established in each study, but the various studies used widely different criteria to establish that diagnosis. Therefore, these calculations are not based on a consistent standard, and comparison between the calculations may be misleading, which underscores the need to develop internationally accepted diagnostic criteria for SS. Studies conducted so far have not shown that parotid sialography is either a sensitive indicator of the salivary component of SS or more closely associated than LSG biopsy with keratoconjunctivitis sicca. the only other component of primary SS with which ultimately to assess diagnostic specificity.

Keywords

Sjogren's syndrome sialography diagnosis parotid gland.

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References

Bloch KJ , Buchanan WW , Wohl MJ , Bunim JJ (1965). Sjogren's syndrome: a clinical, pathological and serological study of sixty-two cases. Medicine 44 :187-231.

Chisholm DM , Blair GS , Low PS , Whaley K. (1971). Hydrostatic sialography as an index of salivary gland disease in Sjogren's syndrome. Acta Radiol Diagn (Stockh) 11:577-585.

Daniels TE (1991). Benign lymphoepithelial lesion and Sjogren's syndrome . In: Surgical pathology of salivary glands. Ellis GL , Auclair FL , Gnepp DR , editors. Philadelphia: W.B. Saunders, pp. 83-106.

Daniels TE (1996). Sjogren's syndrome: Clinical spectrum and current diagnostic controversies. Adv Dent Res 10:3-8.

Daniels TE , Whitcher JP (1994). Association of patterns of labial salivary gland inflammation with keratoconjunctivitis sicca: analysis of 618 patients with suspected Sjogren's syndrome. Arthritis Rheum 37:869-877.

DeClerck LS , Corthouts R. , Francx L. , Brussaard C. , DeSchepper A. , Vercruysse HA , et al. (1988). Ultrasonography and computer tomography of the salivary glands in the evaluation of Sjogren's syndrome. Comparison with parotid sialography. J Rheumatol 15:1777-1781.

Delbalso AM , Ellis GL , Hartman KS , Langlais RP (1990). Diagnostic imaging of the salivary glands and periglandular regions. In: Maxillofacial imaging. Delbalso AM , editor. Philadelphia: W.B. Saunders, pp. 409-510.

Dijkstra PF (1980). Classification and differential diagnosis of sialographic characteristics in Sjogren's syndrome. Semin Arthritis Rheum 10:10-16.

Lindvall AM , Jonsson R. (1986). The salivary gland component of Sjogren's syndrome: an evaluation of diagnostic methods. Oral Surg Oral Med Oral Pathol 62:32-42.

10.

Lowman RM , Cheng GK (1976). Diagnostic roentgenology. In: Diseases of the salivary glands. Rankow RM , Polayes IM , editors. Philadelphia: W.B. Saunders, pp. 54-98.

11.

Manthorpe R. , Oxholm P. , Prause JU , Schiødt M. (1986). The Copenhagen criteria for Sjogren's syndrome . Scand J Rheumatol Suppl 61:19-21.

12.

Markusse HM , van Putten WIJ , Breedveld FC , Oudkerk M. (1993). Digital subtraction sialography of the parotid glands in primary Sjogren's syndrome. J Rheumatol 20:279-283.

13.

Ohfuji T. (1977). Review on research reports. Annual report of the Ministry of Health and Welfare: Sjogren's Disease Research Committee, Japan, pp. 3-6.

14.

Park WM , Mason DK (1966). Hydrostatic sialography. Radiology 86:116-121.

15.

Rabinov K. , Weber AL (1985). Radiology of the salivary glands. Boston: G.K. Hall Medical Publishers, pp. 231-234.

16.

Rubin P. , Besse BE (1957). The sialographic differentiation of Mikulicz's disease and Mikulicz's syndrome. Radiology 68:477-487.

17.

Saito T. , Fukuda H. , Arisue M. , Matsuda A. , Shindoh M. , Amemiya A. , et al. (1991). Relationship between sialographic findings of parotid glands and histopathologic finding of labial glands in Sjogren's syndrome. Relation to clinical and immunologic findings. Oral Surg Oral Med Oral Pathol 72:675-680.

18.

Som PM , Sanders DP (1984). The salivary glands. In: Head and neck imaging excluding the brain. Bergeron RT , Osborn AG , Som PM , editors. St. Louis: C.V. Mosby, pp. 186-234.

19.

Som PM , Shugar JM , Train JS , Biller HF (1981). Manifestations of parotid gland enlargement: radiographic, pathologic and clinical manifestations. Part 1. The autoimmune pseudosialectasis. Radiology 141 :415-419.

20.

Vitali C. , Monti P. , Giuggioli C. , Tavoni A. , Neri R. , Genoversi-Ebert F. , et al. (1989). Parotid sialography and lip biopsy in the evaluation of oral component in Sjogren's syndrome. Clin Exp Rheumatol 7:131-135.

21.

Vitali C. , Bombardieri S. , Moutsopoulos HM , Balestrieri G. , Bencivelli W. , Bernstein PM , et al. (1993). Preliminary criteria for the classification of Sjogren's syndrome. Results of a prospective concerted action supported by the European Community. Arthritis Rheum 36:340-347.

22.

Vitali C. , Moutsopoulos HM , Bombardieri S. (1994). The European Community Study Group on diagnostic criteria for Sjogren's syndrome. Sensitivity and specificity of tests for ocular and oral involvement in Sjogren's syndrome. Ann Rheum Dis 53:637-647.

23.

Whaley K. , Williamson J. , Chisholm DM , Webb J. , Mason DK , Buchanan WW (1973). Sjogren's syndrome. I. Sicca components. Q J Med XVII (166):279-304.

24.

Yoshiura K. , Ohki M. , Araki K. , Yamada M. , Yamada N. (1992). Quantitative evaluation of sialograms. Invest Radiol 27:707-714.