Journal of Indian Academy of Oral Medicine and Radiology (Jan 2009)
Assessment of salivary gland enlargements with the aid of ultrasound-guided FNAC, CT, and MRI: A hospital based diagnostic study
Abstract
Aims and Objectives: Diagnosis of salivary gland enlargements is a demanding task and it requires a thorough knowledge of the clinical presentation of salivary gland diseases and the various imaging modalities available. This study aims at assessing the reliability of ultrasound-guided fine needle aspiration cytology (FNAC) as the first line investigatory procedure for major salivary gland enlargements and to correlate the diagnosis obtained from imaging modalities (Ultrasound guided FNAC, CT or MRI). so that an imaging protocol for salivary gland enlargements can be provided to clinicians, to aid them in preoperative planning. Materials and Methods: Twenty patients with clinically suspected salivary gland enlargements were subjected to ultrasound-guided FNAC, CT and MRI, at appropriate clinical situations. The enlargements found extraglandular in the course of the study were excluded from it. A Chi-square test was applied to obtain the statistical significance and the Galan and Gambino method was applied to find the sensitivity values. Results: The sensitivity of ultrasound-guided FNAC as the first line investigatory procedure for major salivary gland enlargements was found to be 87%. The P value was found to be .0027FNx08 (Statistical significance at 1% level). The sensitivity of imaging modalities combined (USG-guided FNAC, CT and MRI) at appropriate clinical situations to detect benign and malignant neoplasms was found to be 90%. The P value was found to be .0114FNx01 (Statistical significance at 5% level) Conclusion: Ultrasound followed by USG-guided FNAC is the ideal first line investigatory procedure in case of major salivary gland enlargements. The combining of clinical diagnosis with USG-guided FNAC. CT or MRI at appropriate clinical situations gives a more reliable diagnosis.
