Salivary-glands

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1) Sonography of the normal salivary glands:

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A) Submandibular salivary glands:

 

the submandibular salivary gland    color doppler image of submandibular gland

left submandibular gland

The above ultrasound images of the normal submandibular salivary glands show homogenous echotexture and fine soft tissue echogenicity. The color doppler image shows the gland to be vascular. Echogenicity appears slightly less than that of a normal thyroid gland. 

 

B) Parotid gland:

 

The normal parotids:

sonography of normal parotid    color doppler image of the normal parotid

coronal section of the parotid   transverse section of the parotid

The parotid gland is much larger than the submandibular salivary gland. Its transverse diameter is considerably smaller than the coronal dimensions. The parotid shows almost the same texture and echogenicity as the submandibular gland.

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2) Parotitis:

inflammed parotid glands    ultraound image of parotitis

Sonography of the parotid glands in this patient reveal: a) bilateral microabscess formation with b) swollen glands c) hypoechoic lesions. These ultrasound images suggest inflammation s/o parotitis. Sonographic images taken using Philips iU22 machine by Dr. Ravi Kadasne, UAE.

Reference: http://www.emedicine.com/ent/topic600.htm (free article and images)

 

3) Warthin's tumour (cystadenolymphoma):

 

Sonography of salivary gland mass:

ultrasound imaging of the parotid gland       Warthin's tumour of the parotid gland

color doppler image shows Warthins tumour of right parotid     spectral pattern of the flow within the mass

showing the vascular nature of the parotid mass     a smaller mass in the left parotid

both masses of the parotid glands are vascular

This 50 yr. old male patient complained of swelling and pain in the region of the parotid glands on both sides. Sonography of the parotid glands revealed 1) bilateral hypoechoic, well defined masses (larger on the right side) which show no significant acoustic enhancement. 2)The lesion in the right parotid measures 2.5 x 1.6 x 1.2 cms. and that on the left side measures 0.7 cms.3) Fine septae are seen within the masses. 4) Color doppler imaging shows multiple vessels within the mass with typical low velocity flow. These findings suggest either pleomorphic adenoma of the parotids or Warthin's timour. Absence of posterior acoustic enhancement in these ultrasound images suggests that this is a Warthin's tumour of the parotid gland. Histopathological study confirmed this to be Warthin's tumour.

Ultrasound images taken by Joe Antony, MD, using a Toshiba Nemio- XG color doppler machine. 

Reference: http://bjr.birjournals.org/cgi/content/full/76/904/271 ( free article and images).. excellent

4) Parotid abscess:

sonography of parotid abscess     Color and Power Doppler images parotid abscess

anechoic area in right parotid gland     marked vascularity in parotid abscess

Normal left parotid salivary gland  

Sonography of the parotid gland s was done in this 2 yr. old child, to evaluate a swelling in the right parotid region. Ultrasound and Power Doppler / Color Doppler images reveal: a) Marked swelling of the right parotid gland b) multiple anechoic and hypoechoic cystic spaces within the right parotid gland c) marked augmentation of vascularity in the right parotid gland. These ultrasound images suggest right parotid abscess. The child had earlier episodes of pain and swelling in this region. The left parotid gland appears normal.

5) Sialolithiasis: Salivary gland calculus:

Calculus (stone) in parotid duct (Stensen's duct):

dilated ductules of parotid gland    calculus in left Stensen's duct

ultrasound image of stone in dilated parotid duct     3-D image of calculus in parotid duct

This elderly female patient presented with pain and swelling in left parotid region. Sonography of the left parotid gland showed an enlarged parotid gland with dilated branches of the pancreatic duct (see ultrasound image on top left). The left parotid duct (Stensen's duct) appeared markedly dilated with a calculus in the terminal part of the duct (images on top-right and bottom left). The 3-D ultrasound image (bottom right) shows the calculus (stone) in Left Stensen's duct (parotid duct). Sialolithiasis of the parotid duct is relatively rare with most calculi of salivary gland (90 %) being located in the submandibular salivary gland duct (Wharton's duct). If not removed in time, the complications include obstructive sialadenitis (inflammation) and atrophy of the salivary gland. Ultrasound images of sialolithiasis (calculus in Parotid duct) are courtesy of Dr. Ravi Kadasne, UAE.

Reference: 1) http://www.medscape.com/viewarticle/484955_2 (free article)

                 2) http://www.fpnotebook.com/ENT/Salivary/Slths.htm (free article)

 

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  This page was last edited on: Wednesday December 30, 2009 11:56 AM  

Copyright ©   2007- All rights reserved- www.ultrasound-images.com Dr. Joe Antony, MD, Cochin- 20, India.

Scan centre: ULTRASCAN CENTRE, AL-FIA Building, Opp. Reserve Bank of India, ERNAKULAM,

COCHIN (KOCHI)- 682018, KERALA.

Ph: (Off.) 91-484-2403058, (Residence) 91-484-2311416, (Cell) 91- 93886-23088

Contact: joe@ultrasound-images.com or drjoea (at) gmail.com