CT sialography helps diagnose salivary cysts in 22 dogs before surgery

Abstract

Sialoceles are an uncommon canine salivary gland disease, and complete surgical resection is important for a positive outcome. Radiographic sialography has been described as a diagnostic test for presurgical planning; however, superimposition artifacts may limit the diagnosis and detection of all affected glands. Computed tomographic (CT) sialography is a promising technique for delineating the salivary gland apparatus. The aims of this retrospective, observational study were to describe clinical and CT sialographic findings in a group of dogs with confirmed sialoceles, to determine the sensitivity of CT sialography for detecting affected salivary glands using surgery as the reference standard and to determine interobserver agreement for CT sialographic assessments. Dogs were included if they underwent a CT sialography study followed by surgical resection of the diseased gland(s) and histopathological analysis. Computed tomography sialography studies of dogs with surgically confirmed sialoceles (n = 22) were reviewed by a European College of Veterinary Diagnostic Imaging (ECVDI)-certified radiologist and an ECVDI resident. Interobserver agreement was calculated using Cohen's kappa statistics. CT sialography results were compared to surgical findings to determine sensitivity. Contrast leakage was detected in 12 of 22 dogs (54.5%), with intrasialocele leakage being most frequently observed (7/12, 58.3%). There was substantial agreement (κ = 0.70) between reviewers identifying diseased glands, substantial agreement (κ = 0.62) on the diagnostic quality, and no to slight agreement (к = 0.13) in the detection of contrast leakage. The overall sensitivity of CT sialography to detect surgically confirmed diseased glands was 66.7% (95% confidence interval: 48.8-80.8). In conclusion, these findings support the use of CT sialography as an adjunct diagnostic test for treatment planning in dogs with sialoceles.