RadteraSialogram (Salivary Gland Ductogram)
Fluoro+ ContrastHead & Neckverify
Indications
- Recurrent salivary gland swelling (suspected sialolithiasis or stricture)
- Ductal obstruction / stenosis evaluation
- Chronic sialadenitis
- Sjögren syndrome (sialectasis pattern)
- Pre-treatment ductal mapping (parotid/submandibular)
Patient prep
- Exclude acute infection (relative contraindication — risk of spreading infection / pain)
- Locate and gently dilate the duct orifice (Stensen for parotid, Wharton for submandibular)
- Have a sialagogue (e.g., lemon/citrus) available for post-procedure emptying images
Contrast
AgentWater-soluble iodinated contrast (low volume); historically oil-based was used
Routeretrograde via cannulation of the salivary duct orifice
DoseSmall volume injected slowly until ductal filling / patient feels fullness (typically ~0.5-2 mL)
TimingFluoroscopy during slow injection; post-sialagogue emptying images
Technique
- Identify and cannulate the duct orifice with a fine sialography cannula/catheter
- Inject water-soluble contrast slowly under fluoroscopy until the ductal tree fills (stop when patient feels fullness)
- Acquire spot images of the main duct and intraglandular branches in multiple obliquities
- Administer a sialagogue and obtain delayed emptying images to assess ductal drainage/retention
Series / Sequences
| # | Series / Sequence | Plane | Notes |
|---|---|---|---|
| 1 | Scout | Lateral / oblique of gland | Radiopaque calculi |
| 2 | Filling phase | Lateral + oblique | Main duct and branches — strictures, filling defects (stones), sialectasis |
| 3 | Post-sialagogue emptying | Lateral | Drainage, retention, residual obstruction |
Key points
- Avoid in acute sialadenitis (can worsen infection and is very painful)
- Inject only a small volume slowly — overdistention is painful and can cause ductal rupture/extravasation
- Use water-soluble iodinated contrast; avoid air bubbles (mimic calculi)
- Sjögren shows punctate/globular sialectasis; chronic sialadenitis shows sialectasis and strictures (sausage-link duct)
- MR sialography and US increasingly used as non-invasive alternatives; interventional sialography can also treat strictures/stones
References
• Radiopaedia: Sialography
• ACR–ASNR–SNIS practice parameters (head & neck imaging context)
• Standard head & neck radiology references (e.g., Som & Curtin)
• ACR–ASNR–SNIS practice parameters (head & neck imaging context)
• Standard head & neck radiology references (e.g., Som & Curtin)
Source: Researched — verify against your institution
‹ PreviousModified Barium Swallow Study (MBSS / VFSS, with Speech)Next ›Parathyroid Scan (Tc-99m Sestamibi)
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.