CT scan assessment in salivary gland lithiasis diagnosis

The aim of the study was to assess computed tomography (CT) scan efficiency for the diagnosis of salivary lithiasis.

Patients who were included were all the patients who consulted in our department for main salivary gland (submandibular and parotid) obstruction symptoms between June 2014 and December 2016. A CT scan without injection was prescribed for all of them. The 163 patients were divided into two groups after the CT scan: patients with and without lithiasis. During surgery, we confirmed the presence or absence of the lithiasis previously diagnosed on the CT scan. The patients were divided in two groups: case and control groups. For statistical analysis, the sensitivity, specificity, and the negative and positive predictive values of the preoperative CT scan were calculated.

A total of 163 patients with a salivary obstructive syndrome were included. On the CT scans, we found lithiases (hyperdense images) in 157 glands ("CT scan⊕" group), and we found no lithiasis in 6 glands ("CT scan" group). In the "CT scan⊕" group, 203 lithiases were present. During surgery, we found and removed lithiases in 155 patients (case group), and 8 patients had no lithiases (control group). The overall sensitivity, specificity, positive predictive value, and negative predictive values of the CT scan for the detection of lithiasis were 100%, 75%, 99%, and 100%, respectively. The specificity of CT scans for the lithiasis located in the anterior and middle third of the duct was 100%.

According to our study, the CT scan is very efficient in diagnosing salivary main gland lithiases in patients with an obstructive syndrome.