The key role of magnetic resonance sialography in the differential diagnosis between sialolith and phlebolith of the floor of the mouth.

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

BMC Oral Health Pub Date : 2025-10-14 DOI:10.1186/s12903-025-06795-5

Alvaro Sánchez Barrueco, Gonzalo Díaz Tapia, Félix Guerra Gutiérrez, Elena Salvador Álvarez, José Miguel Villacampa Aubá

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Abstract

Background: The confusion between a phlebolith and a sialolith in the floor of the mouth can pose serious surgical risks, making it essential to define appropriate complementary imaging studies.

Case presentation: We present the case of a patient with right submandibular sialolithiasis suspected by computed tomography. A previous attempt at extraction in another centre, under local anesthesia, was interrupted due to profuse bleeding, preventing the localization and removal of the calculi. Due to our pre-surgical study protocol using magnetic resonance sialography (MR-Si), a low-flow vascular malformation with internal phleboliths was revealed, without involvement of the salivary duct. As a result, the planned sialendoscopy was cancelled, and a follow-up approach was chosen given the asymptomatic nature of the condition.

Conclusions: This case underscores the importance of standardizing radiological studies for salivary gland and floor-of-mouth pathology, highlighting MR-Si for its high sensitivity and specificity. Therefore, MR-Si enables more precise surgical planning and helps prevent unnecessary intraoperative complications.

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磁共振唾液造影在鉴别诊断口腔底的唾液石和静脉石中的关键作用。

背景：口腔底部的静脉石和唾液石之间的混淆可能会造成严重的手术风险，因此有必要确定适当的补充影像学研究。病例介绍：我们提出一个病例的病人与右下颌下涎石怀疑通过计算机断层扫描。之前在另一个中心进行的局部麻醉下的拔牙尝试，由于大量出血而中断，无法定位和取出结石。由于我们的术前研究方案使用磁共振唾液造影（MR-Si），低流量血管畸形与内部静脉结石被发现，没有涉及到唾液管。结果，计划的唾液内窥镜检查被取消，考虑到病情的无症状性，选择了随访方法。结论：该病例强调了唾液腺和口底病理标准化放射学研究的重要性，突出了MR-Si的高灵敏度和特异性。因此，MR-Si可以实现更精确的手术计划，并有助于防止不必要的术中并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Oral Health DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.90

自引率

6.90%

发文量

481

审稿时长

6-12 weeks

期刊介绍： BMC Oral Health is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of disorders of the mouth, teeth and gums, as well as related molecular genetics, pathophysiology, and epidemiology.