From the Departments of Radiology (Y.M.P., R.G.K., A.M.C., A.G.C., R.P.K.)
From the Departments of Radiology (Y.M.P., R.G.K., A.M.C., A.G.C., R.P.K.).
AJNR Am J Neuroradiol. 2017 Nov;38(11):2161-2166. doi: 10.3174/ajnr.A5353. Epub 2017 Aug 24.
Sialolithiasis is a common benign pathology affecting the salivary glands but it is unclear if contrast-enhanced CT, which is commonly used for investigation of head and neck pathology, can identify calculi as accurately as noncontrast CT. The aim of this study was to assess the diagnostic accuracy of contrast-enhanced CT of the neck in the diagnosis of sialolithiasis compared with noncontrast CT of the neck used as the criterion standard.
This was a retrospective, case-control study of 92 consecutive cases in 90 patients who underwent both noncontrast CT of the neck and contrast-enhanced CT of the neck in 2 tertiary referral centers from January 2011 to December 2015 for investigation of sialolithiasis. Axial 3-mm-section images were assessed by a fellowship-trained diagnostic neuroradiologist and diagnostic neuroradiology fellow in consensus. Blinded assessment of the contrast-enhanced CT of the neck was performed first, followed by noncontrast CT of the neck after a 2-week interval. The presence or absence of a stone and stone location and size were documented. Statistical analysis was undertaken to assess the agreement between CT protocols and calculate the sensitivity and specificity of contrast-enhanced CT of the neck.
Fifty calculi were identified on noncontrast CT of the neck in 31 cases; and 48 calculi, in 31 cases on contrast-enhanced CT of the neck. No calculi were identified in the remaining 61 cases. The sensitivity and specificity of contrast-enhanced CT of the neck in the detection of sialolithiasis was 96% (95% CI, 86.3%-99.5%) and 100% (95% CI, 94.1%-100%), respectively. The positive predictive value of contrast-enhanced CT of the neck was 100% (95% CI, 92.6%-100%), and the negative predictive value was 96.8% (95% CI, 89%-99.6%). The accuracy of contrast-enhanced CT of the neck in diagnosing the presence or absence of salivary calculi was 98%.
Contrast-enhanced CT of the neck is accurate in the detection of sialolithiasis, with no difference in diagnostic accuracy compared with noncontrast CT of the neck.
涎石病是一种常见的良性涎腺疾病，但目前尚不清楚颈部对比增强 CT 是否能像非增强 CT 一样准确地识别结石。本研究旨在评估颈部对比增强 CT 在诊断涎石病方面的诊断准确性，并与作为金标准的颈部非增强 CT 进行比较。
这是一项回顾性病例对照研究，共纳入 90 例患者的 92 例连续病例，这些患者于 2011 年 1 月至 2015 年 12 月在 2 家三级转诊中心因涎石病行颈部非增强 CT 和颈部对比增强 CT 检查。由一名神经放射学研究员和一名神经放射学研究员进行共识评估，使用轴向 3mm 层厚图像。首先进行颈部对比增强 CT 的盲法评估，然后在 2 周间隔后进行颈部非增强 CT 的评估。记录结石的存在、位置和大小。进行统计学分析以评估两种 CT 方案之间的一致性，并计算颈部对比增强 CT 的敏感性和特异性。
在 31 例患者的颈部非增强 CT 上发现 50 个结石，在 31 例患者的颈部对比增强 CT 上发现 48 个结石。在其余 61 例患者中未发现结石。颈部对比增强 CT 检测涎石病的敏感性和特异性分别为 96%（95%可信区间，86.3%-99.5%）和 100%（95%可信区间，94.1%-100%）。颈部对比增强 CT 的阳性预测值为 100%（95%可信区间，92.6%-100%），阴性预测值为 96.8%（95%可信区间，89%-99.6%）。颈部对比增强 CT 诊断涎石病存在或不存在的准确性为 98%。
颈部对比增强 CT 对涎石病的检测准确，与颈部非增强 CT 相比，其诊断准确性无差异。
