Comparison of the sonographic features of acalculous and calculous submandibular sialadenitis

• Published in: Journal of clinical ultrasound 2001-07, Vol.29 (6), p.332-338
• Main Authors: Ching, Alex Sik-Chung, Ahuja, Anil T., King, Ann D., Tse, Gary Man-Kit, Metreweli, Constantine
• Format: Article
• Language: English
• Subjects: acalculous sialadenitis; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biopsy, Needle; Diagnosis, Differential; Ent, orbit; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Non tumoral diseases; Otorhinolaryngology. Stomatology; Retrospective Studies; Salivary Gland Calculi - diagnostic imaging; Salivary Gland Calculi - pathology; submandibular gland; Submandibular Gland Diseases - diagnostic imaging; Submandibular Gland Diseases - pathology; Ultrasonic investigative techniques; ultrasonography; Ultrasonography - instrumentation; Ultrasonography - methods; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 0091-2751; 1097-0096
• DOI: 10.1002/jcu.1044

Objective The purpose of this study was to compare the sonographic features of acalculous and calculous sialadenitis of the submandibular gland. Methods A retrospective review of sonograms of the neck was performed in 25 patients with submandibular sialadenitis: 8 with acalculous and 17 with calculous disease. The submandibular glands were assessed for size, shape, border, and echogenicity; presence of dilated ducts or other intraglandular lesions; inflammatory changes in adjacent tissues; lymphadenopathy; and involvement of other salivary glands. Results In the group with acalculous sialadenitis, 4 (50%) of the 8 patients had unilateral disease, and 11 (92%) of 12 glands were rounded. In all cases (100%), multiple hypoechoic lesions were diffusely distributed throughout the submandibular glands against a heterogeneous parenchymal background. The lesions ranged from 3 to 15 mm and were oval or round. Confluent lesions were noted in 2 glands (17%). There was no sonographic evidence of duct dilatation, calculi, or abnormal lymph nodes. All patients with calculous sialadenitis had unilateral disease; 9 had a main duct calculus (53%), 7 had intraglandular calculi (41%), and 1 had both (6%). In 14 (82%) of 17 glands, normal shape was maintained, and 11 (65%) of 17 had duct dilatation. Conclusions Acalculous submandibular sialadenitis differs from the calculous form of the disease. The former has characteristic sonographic features, including a round gland with numerous hypoechoic lesions in a heterogeneous parenchymal background. Sonographic imaging in conjunction with fine‐needle aspiration is useful for detection of this disorder. © 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:332–338, 2001.