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Subject Area

Endemic and Tropical Medicine

Article Type

Original Study

Abstract

Objectives To establish the diagnostic accuracy of magnetic resonance sialography (MRS) when compared with the gold standard conventional sialography (CS) in patients with suspected salivary gland disease. Background This is a systematic review and meta-analysis to compare both studies. CS is still considered the standard modality for assessing ductal abnormalities. MRS has been applied as an alternative. Methods We searched PubMed, Cochrane CENTRAL, Scopus, Science Direct, and Web of Science for all studies that compared MRS versus CS regarding radiological outcomes and diagnostic performance as primary outcomes. Combined outcomes were pooled as risk ratios in a fixed model or diagnostic odds ratio (DOR) in a random model, using Reviewer Manager 5.3 and Meta-DiSc 1.4 for Windows. Results Eight studies (n = 285 patients) were included in the final analysis. Our results showed that MRS was effective in the detection of main duct according to patients more than CS [risk ratio = 0.84, 95% confidence interval (CI), 0.71–1, P = 0.05). However, it showed no significant difference between the two groups in detection of main duct according to glands. Moreover, there are no significant differences between MRS and CS regarding detection of sialolithiasis, sialectasis, stenosis with stones, or strictures. The diagnostic performance in the detection of sialolithiasis according to glands was as follow: the pooled sensitivity was 0.88 (95% CI, 0.75–0.95), the pooled specificity was 0.98 (95% CI, 0.93–1.00), and the pooled DOR under random effect was 181.64 (95% CI, 39.420–837). Moreover, the diagnostic performance in the detection of the stenosis with stones according to patients was as follows: the pooled sensitivity was 0.727 (95% CI, 0.498–0.893), the pooled specificity was 0.979 (95% CI, 0.889–0.99), and the diagnostic odds ratio under random effect was 78.73 (95% CI, 2.18–508.81). Conclusion There is no difference between MRS and CS in radiological findings except in case of detection of main duct according to patients, which indicates that MRS is more effective in revealing the proper information about main salivary ducts. Moreover, MRS provides a noninvasive alternative to CS especially if acute sialadenitis is present or cannulation is not successful.

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