Application of sialography in diagnosis and differential diagnosis of igg4-related sialadenitis. A systematic review.

Dr. Dharmapuri Govindhan Dharani  Dharan1; Dr. Karthik  Shunmugavelu; Vidharshana SA

doi:10.51168/sjhrafrica.v7i3.2505

Authors

Dr. Dharmapuri Govindhan Dharani Dharan Private practice Mediscan systems No 197 , dr natesan road Mylapore chennai 600004 Tamilnadu
Dr. Karthik Shunmugavelu Assistant Professor, Department of Dentistry, PSP medical college hospital and research institute Tambaram Kanchipuram main road Oragadam Panruti Kanchipuram district Tamilnadu 631604 India.
Vidharshana Undergraduate (MBBS). PSP medical college hospital and research institute Tambaram Kanchipuram main road Oragadam Panruti Kanchipuram district Tamilnadu 631604 India.

DOI:

https://doi.org/10.51168/sjhrafrica.v7i3.2505

Keywords:

Salivary glands, IgG4-related sialadenitis, Chronic obstructive submandibular sialadenitis, Differential diagnosis, Ultrasound, Sialography, Benign salivary gland obstruction

Abstract

Background:
Immunoglobulin G4-related disease (IgG4-RD) is a systemic fibroinflammatory condition frequently involving salivary glands. IgG4-related sialadenitis often mimics neoplastic and other inflammatory disorders, creating diagnostic difficulty. Sialography provides detailed visualization of salivary ductal architecture and may aid in differentiation.

Methodology:
A systematic review was conducted using PubMed, Scopus, Embase, Web of Science, and LILACS databases for studies published between 2020 and 2024. Original research articles focusing on imaging or diagnosis of IgG4-related sialadenitis were included. Study selection and data extraction were performed independently by two reviewers. Extracted variables included study design, sample size, imaging modality, and diagnostic findings. Study quality was assessed using STROBE criteria. Due to heterogeneity, a narrative synthesis was undertaken.

Results:
A total of 11 studies met the inclusion criteria. Sialography demonstrated characteristic ductal changes such as ductal irregularities, segmental narrowing, and sialectasis. These features were useful in differentiating IgG4-related sialadenitis from conditions such as Sjögren’s syndrome and obstructive sialadenitis. Diagnostic accuracy improved when sialography was combined with other imaging modalities including ultrasound, CT, and MRI. Evidence quality was low to moderate due to observational study designs and heterogeneity.

Conclusion:
Sialography serves as a valuable adjunctive imaging modality for evaluating ductal morphology in IgG4-related sialadenitis. However, it is not sufficient as a standalone diagnostic tool and should be interpreted alongside clinical, serological, and histopathological findings.

Recommendation:
A multimodal diagnostic approach integrating imaging, serology, and histopathology is recommended for accurate diagnosis. Future studies with standardized imaging protocols and larger sample sizes are required to establish the definitive diagnostic role of sialography.

Author Biographies

Dr. Dharmapuri Govindhan Dharani Dharan, Private practice Mediscan systems No 197 , dr natesan road Mylapore chennai 600004 Tamilnadu

is a dental practitioner based in Chennai, India, associated with Mediscan Systems. His clinical work focuses on diagnostic oral pathology and salivary gland disorders. His research interests include imaging-based diagnosis and clinicopathological correlation in oral diseases.

Dr. Karthik Shunmugavelu, Assistant Professor, Department of Dentistry, PSP medical college hospital and research institute Tambaram Kanchipuram main road Oragadam Panruti Kanchipuram district Tamilnadu 631604 India.

is an Assistant Professor in the Department of Dentistry at PSP Medical College Hospital and Research Institute, Tamil Nadu, India. He specializes in Oral and Maxillofacial Pathology with international academic affiliations. His research focuses on oral potentially malignant disorders, biomarkers, and advanced diagnostic techniques.

Vidharshana

Vidharshana, Undergraduate (MBBS). PSP medical college hospital and research institute Tambaram Kanchipuram main road Oragadam Panruti Kanchipuram district Tamilnadu 631604 India.

is an undergraduate medical student (MBBS) at PSP Medical College Hospital and Research Institute, Tamil Nadu, India. She has an academic interest in systemic diseases with oral manifestations and diagnostic imaging. Her work includes participation in clinical research and systematic reviews.

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