Learning objectives
The purpose of this educational exhibit is:
To revise the anatomy of the major salivary glands;
To understand the ultrasound approach to assessment of the major salivary glands;
To recognise the imaging appearancesof the most frequently encountered benign salivary pathology including sialolithiasis,
sialadenitis and systemic illness such as Sjogrens disease.
Background
The major salivary glands can be affected by a wide range of pathology,
however as these can be relatively uncommon the general radiologist may be unfamiliar with the imaging appearances.
It is essential to be able to differentiate benign disease from malignancy.
Ultrasound provides an easily accessible and non-invasive method of assessment of the major salivary glands.
It is readily available and widely accepted as the first choice of imaging modality in Europe and Asia,
whereas in the US the firstline is more often MR...
Findings and procedure details
Anatomy of the major salivary glands
The paired parotid,
submandibular and sublingual glands make up the major salivary glands.
Further minor salivary glands are found over the palate,
lips,
cheeks,
tonsils and tongue.
2
The parotid glands are the largest salivary glands and secrete only serous fluid.
Eachgland is positioned between the ramus of the mandible and the styloid process,with the duct opening lateral to the second upper molar tooth.2 The internal jugular vein,
external carotid artery and facial nerve traversethrough the gland.
The gland...
Conclusion
A number of benign conditions can present in the paired major salivary glands.
Ultrasound provides a non-ionising,
relatively inexpensive and reproducible method of assessment in superficial lesions,
whereas cross-sectional imaging such as MRI is reserved for larger or more complex lesions.
We present the imaging characteristics of the most frequently encounteredbenign salivary pathology.
Personal information
Dr Scott Rice:
UCL Centre for Medical Imaging,3rd Floor East,250 Euston Road,London NW1 2PG.
[email protected]
Dr GemmaPrice:
UCLH Foundation NHS Trust,235 Euston Road,London NW1 2BU.
Dr Shivani Patel:
UCLH Foundation NHS Trust,235 Euston Road,London NW1 2BU.
Dr Simon Morley:
UCLH Foundation NHS Trust,235 Euston Road,London NW1 2BU.
Dr Timothy Beale:
UCLH Foundation NHS Trust,235 Euston Road,London NW1 2BU
References
1.
Bialek EJ,
Jakubowski WJ,
Zajkowsi P,
Szopinski KT,
Osmolski A.
US of the major salivary glands: Anatomy and spatial relationships,
pathologic conditions and pitfalls.
Radiographics 2006; 26: 745-763.
2.
Moore KL,
Dalley AF.
Clinically orientated anatomy,
Fourth edition.
Lippincott,
Williams and Wilkins.
3.
Yousem DM,
Kraut MA,
Chalian AA.
Major Salivary Gland Imaging.
Radiology 2000; 216: 19-29.
4.
Weissleder,
R.
(2011).
Primer of diagnostic imaging.