Three-dimensional cone-beam computed tomographic sialography in the diagnosis and management of primary Sjögren syndrome: Report of 3 cases

Thomas, Nithin; Kaur, Aninditya; Reddy, Sujatha S; Rakesh, N; Nagi, Ravleen; Shankar, Vidya Gurram

doi:10.5624/isd.20200313

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…This facilitates the identification of specific anatomical changes, and it is more cost-effective and convenient for patients. [44][45][46] However, the ability to detect early or small lesions might be overlooked. 47 This study has several limitations.…”

Section: Discussionmentioning

confidence: 99%

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New‐onset primary Sjögren's syndrome following exposure to severe acute respiratory syndrome coronavirus 2: A retrospective cohort study

Liu,

Zhang,

Liu

et al. 2024

Rheumatology & Autoimmunity

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BackgroundUnderstanding the clinical implications of autoimmune manifestations associated with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is essential to reduce its consequences. This study was aimed at determining the activities of new‐onset primary Sjögren syndrome (pSS) since the emergence of SARS‐CoV‐2.MethodsThis retrospective cohort study included data from 471 participants with dry mouths and eyes who had been attending Nanjing Drum Tower Hospital since December 2019. By April 2023, patients diagnosed with pSS were sequentially assigned to vaccinated group (n = 24) or vaccinated and infected group based on exposure (n = 20). Patients diagnosed with pSS within 3 months of vaccination against SARS‐CoV‐2 were assigned to a vaccinated group, and those who had been vaccinated and then developed pSS within 3 months of follow up after direct exposure to SARS‐CoV‐2 were assigned to a vaccinated and infected group. The controls comprised age‐ and sex‐matched patients who had not been exposed to SARS‐CoV‐2 before December 2019 (n = 21). We then compared data among the three groups.ResultsThe vaccinated and infected patients had more fever, malaise, splenomegaly, and weight loss before diagnosis and a higher European Alliance of Associations for Rheumatology Sjögren's syndrome disease activity index at the time of onset than the other two groups. Vaccinated patients had a higher frequency of anti‐nuclear antibody (ANA) titers > 1:320 (n = 12; 50%) and anti‐phospholipid antibodies (aPL) (n = 7; 29%) than the controls. The frequency of anti‐Ro/SSA antibodies (13, 65%), ANA titers > 1:320 (n = 16; 80%), and aPLs (n = 7; 29%) (n = 5; 25%) were all significantly higher in vaccinated patients with infection than those in the controls. Higher doses of glucocorticoids, cyclosporin A, and tacrolimus were administered to the vaccinated and infected than the vaccinated and control groups (p < 0.05, for all).ConclusionsPatients with new‐onset pSS and a history of vaccination and SARS‐CoV‐2 infection might have more active disease. Further strengthening the assessment of people with a clear history of SARS‐CoV infection and the monitoring of potential populations for autoimmune screening should not be overlooked.

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Section: Discussionmentioning

confidence: 99%

“…This was because conventional parotid imaging has better resolution and generates clearer images of the parotid structures. This facilitates the identification of specific anatomical changes, and it is more cost‐effective and convenient for patients 44–46 . However, the ability to detect early or small lesions might be overlooked 47 …”

Section: Discussionmentioning

confidence: 99%

New‐onset primary Sjögren's syndrome following exposure to severe acute respiratory syndrome coronavirus 2: A retrospective cohort study

Liu,

Zhang,

Liu

et al. 2024

Rheumatology & Autoimmunity

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“…By allowing detailed exploration of the ductal tree and late evacuation imaging, it provides assessment of salivary gland function and obstructive conditions [ 11 , 12 ]. Three-dimensional (3D)-cone-beam computed tomography (CBCT) sialography is becoming increasingly common as it provides fast high spatial resolution 3D images of the ductal system [ 13 , 14 ]. Several studies have shown the superiority of 3D-CBCT sialography compared to conventional sialography for visualization of ducts up to the 6th branch of division and for detection of stenosis and sialolithiasis [ 15 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

A comparative study of three-dimensional cone-beam CT sialography and MR sialography for the detection of non-tumorous salivary pathologies

Bertin,

Bonnet,

Le Thuaut

et al. 2023

BMC Oral Health

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Background Imaging of the salivary ductal system is relevant prior to an endoscopic or a surgical procedure. Various imaging modalities can be used for this purpose. The aim of this study was to compare the diagnostic capability of three-dimensional (3D)-cone-beam computed tomography (CBCT) sialography versus magnetic resonance (MR) sialography in non-tumorous salivary pathologies. Methods This prospective, monocenter, pilot study compared both imaging modalities in 46 patients (mean age 50.1 ± 14.9 years) referred for salivary symptoms. The analyses were performed by two independent radiologists and referred to identification of a salivary disease including sialolithiasis, stenosis, or dilatation (primary endpoint). The location and size of an abnormality, the last branch of division of the salivary duct that can be visualized, potential complications, and exposure parameters were also collected (secondary endpoints). Results Salivary symptoms involved both the submandibular (60.9%) and parotid (39.1%) glands. Sialolithiasis, dilatations, and stenosis were observed in 24, 25, and 9 patients, respectively, with no statistical differences observed between the two imaging modalities in terms of lesion identification (p1 = 0.66, p2 = 0.63, and p3 = 0.24, respectively). The inter-observer agreement was perfect (> 0.90) for lesion identification. MR sialography outperformed 3D-CBCT sialography for visualization of salivary stones and dilatations, as evidenced by higher positive percent agreement (sensitivity) of 0.90 [95% CI 0.70–0.98] vs. 0.82 [95% CI 0.61–0.93], and 0.84 [95% CI 0.62–0.94] vs. 0.70 [95% CI 0.49–0.84], respectively. For the identification of stenosis, the same low positive percent agreement was obtained with both procedures (0.20 [95% CI 0.01–0.62]). There was a good concordance for the location of a stone (Kappa coefficient of 0.62). Catheterization failure was observed in two patients by 3D-CBCT sialography. Conclusions Both imaging procedures warrant being part of the diagnostic arsenal of non-tumorous salivary pathologies. However, MR sialography may be more effective than 3D-CBCT sialography for the identification of sialolithiasis and ductal dilatations. Trial registration NCT02883140.

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“…Sialography was initially described in 1902 by Carpy and remains the most accurate method for imaging the salivary ductal system. It provides a cost effective and safe diagnostic solution that can be routinely employed as a screening procedure for salivary gland pathologies, namely aberrations in the ductal system, sialoliths and Sjögren’s syndrome [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Anatomical Features of the Parotid Duct in Sialography as an Aid to Endoscopy—A Retrospective Study

et al. 2022

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Sialography is used for diagnosis of obstructive salivary gland diseases and prior to sialendoscopy. Three-dimensional cone beam computerized tomography (CBCT) sialography allows imaging and measurement of salivary duct structures. Salivary gland endoscopy has a long learning curve. The aim of this retrospective study is to create an anatomical quantitative guide of different distances and angles significant for endoscopy. Twenty-six CBCT sialographies of healthy parotid ducts were included. Outcome parameters included diameters, distances, angles and number of minor tributaries. Results show the average distance from the papilla to the curvature of the gland was 41.5 mm (Q1 36.97 mm–Q3 45.32 mm), with an angle of 126.9° (Q1 107.58°–Q3 135.6°) of the curvature and a distance of 35.25 mm (±7.81 mm) between the curvature and the hilus. The mean width of the duct was 0.8 mm (Q1 0.7 mm–Q3 1.15 mm) at its narrowest and 2 mm (Q1 1.4 mm–Q3 2.2 mm) at its widest. This is the first anatomical quantitative study of the parotid duct in relation to sialendoscopy.

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Three-dimensional cone-beam computed tomographic sialography in the diagnosis and management of primary Sjögren syndrome: Report of 3 cases

Cited by 7 publications

References 16 publications

New‐onset primary Sjögren's syndrome following exposure to severe acute respiratory syndrome coronavirus 2: A retrospective cohort study

New‐onset primary Sjögren's syndrome following exposure to severe acute respiratory syndrome coronavirus 2: A retrospective cohort study

A comparative study of three-dimensional cone-beam CT sialography and MR sialography for the detection of non-tumorous salivary pathologies

Anatomical Features of the Parotid Duct in Sialography as an Aid to Endoscopy—A Retrospective Study

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