Magnetic resonance sialography

To evaluate a new noninvasive sialographic technique, we applied a new magnetic resonance technique to 10 healthy volunteers and 21 patients with lesions of the parotid gland. In addition to the usually performed T₁ and T₂ cross-sectional sequences, a heavily T₂-weighted sequence (TR = 3600 msec, TE = 800 msec) was performed that allowed depiction of the fluid-filled parotid duct system. Twenty-one patients with benign as well as malignant parotid gland pathologies were examined: sialadenitis (n = 6), sicca syndrome (n = 2), pleomorphic adenoma (n = 4), carcinoma of the parotid gland (n = 2), lymphoepithelial carcinoma (n = 1), cystadenolymphoma (n = 3), non-Hodgkin's lymphoma (n = 2), and congenital duct dilatation (n = 1). Stensen's duct was reliably depicted in all volunteers and patients. The primary branching ducts were reliably depicted in all normal cases. Intraglandular and extraglandular duct dilatations and duct strictures were well depicted in patients with chronic sialadenitis. Sialolithiasis with a calculus obstructing the duct was demonstrated in 2 cases. In conclusion, initial experience indicates that magnetic resonance sialography can be applied successfully to investigate the duct system of the parotid gland. The usually performed cross-sectional MRI (T₁- and T₂-weighted images, gadolinium-DTPA) depicts the internal architecture of the parotid gland with high reliability. Magnetic resonance sialography with heavily T₂-weighted images adds important information about the ductal system. Because it is completely noninvasive, the only contraindications are the ones generally accepted for MRI.