What is the role of ultrasonography in the diagnosis of submandibular sialadenitis/sialadenosis?

Updated: May 12, 2020
  • Author: Adi Yoskovitch, MD, MSc; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Ultrasonography can be used to differentiate between solid versus cystic lesions of the gland. It can also be used to differentiate intrinsic from extrinsic disease and can be helpful in identification of abscess formation. A 2009 study by Bozzato et al determined that application of ascorbic acid (vitamin C) as a contrast agent can aid in the ultrasound assessment of obstructive sialadenitis of the parotid and submandibular glands. [4, 5]

A study by Omotehara et al indicated that ultrasonography is effective in the diagnosis of immunoglobulin G4–related sclerosing sialadenitis (IgG4-SS), with ultrasonography showing the submandibular gland to have a significantly greater longitudinal diameter and thickness in patients with IgG4-SS than in controls. In addition, a rough contour to the gland was found in 62.9% of the patients, versus 8.3% of the controls. Moreover, in an examination of internal echo textures, patients showed multiple hypoechoic nodule patterns or diffuse hypoechoic patterns, in contrast to controls, who were found to have only homogeneous echo textures. Additionally, significantly higher color Doppler signaling was observed in cases of IgG4-SS than in controls. [6, 7]

In an examination of the parotid and submandibular glands, a study by Li et al suggested that ultrasonography may also be helpful in posttreatment follow-up of IgG4 sialadenitis, finding that the treated glands decreased significantly in volume and that their internal echoes showed greater homogeneity. [8]

A study by Larson et al indicated that in terms of identifying sialoliths intraoperatively in patients with chronic obstructive sialadenitis, surgeon-performed ultrasonography has positive and negative predictive values of are 94% and 91%, respectively. [9]


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