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State of the Art |
1 From the Department of Radiology, Johns Hopkins Hospital, 600 N Wolfe St, Houck B-112, Baltimore, MD 21287 (D.M.Y., M.A.K.), and the Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia (A.A.C.). Received January 22, 1999; revision requested March 30; final revision received August 6; accepted August 18. Address correspondence to D.M.Y. (e-mail: yousem@rad.jhu.edu).
The algorithm for imaging the salivary glands depends on the clinical scenario with which the patient presents to the clinician. Because of the importance of identifying small calculi in the gland or salivary duct as the cause of the symptom complex, nonenhanced computed tomography is often the best initial study for the evaluation of the painful gland. If an infiltrative neoplasm is highly suspected, nonenhanced and enhanced magnetic resonance (MR) imaging may be superior in demonstrating perineural, meningeal, and skull base invasion. Sialography is reserved for the evaluation of chronic sialadenitides unrelated to sialolithiasis. Thin-section MR techniques for MR sialography may soon replace conventional sialography.
Index terms: Salivary glands, calculi, 264.818 • Salivary glands, CT, 264.12111, 264.12112 • Salivary glands, diseases, 264.247 • Salivary glands, MR, 264.12141, 264.12143 • Salivary glands, neoplasms, 264.363, 264.37
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