American Journal of Roentgenology, Vol 163, 933-941, Copyright © 1994 by American Roentgen Ray Society

ARTICLES

Color Doppler sonography of salivary glands

C Martinoli, LE Derchi, L Solbiati, G Rizzatto, E Silvestri and M Giannoni
Istituto di Radiologia, Universita di Genova, Italy.

OBJECTIVE. We used color Doppler sonography to evaluate the vascular anatomy of the salivary glands and to analyze physiologic changes that occur during salivary stimulation in normal subjects and the flow alterations that occur in diseased glands. SUBJECTS AND METHODS. The vascular appearance of the three major salivary glands was examined in healthy volunteers (n = 24); in patients with chronic autoimmune diseases, including Sjogren's syndrome (n = 23) and salivary sarcoidosis (n = 2); and in a variety of benign (n = 49) and malignant (n = 13) nodules. Physiologic changes were assessed in healthy volunteers by means of a stimulation test with lemon and were quantified with color images and spectral analysis. Tumor vascularity was graded on a four-step analog scale of 0 to (+3) and classified as either peripheral or hilar, depending on the distribution of vessels. RESULTS. In the control subjects, color Doppler imaging accurately reflected the complex vascular anatomy of the salivary glands and showed dramatic changes occurring in parenchymal vessels during lemon stimulation as a result of the intense hyperemia associated with the secretion of saliva. Sjogren's syndrome and sarcoidosis showed a diffuse hypervascular pattern when morphologic changes of salivary parenchyma were seen on gray-scale sonograms. Benign tumors showed a lower grade of vascularity than did malignant tumors. All but one of the hypovascular nodules graded as 0 (n = 8) and + (n = 23) were benign. Conversely, eight of 11 nodules labeled with the highest grade of tumor vascularity (+3) were malignant. When the pattern of tumor flow signals was peripheral, it could be considered specific enough to aid in diagnosing pleomorphic adenoma. Peak systolic velocities greater than 60 cm/sec were never detected in benign tumors and were seen in only 44% of malignant tumors. CONCLUSION. Color Doppler sonography is a promising technique for analyzing the vascularity of the salivary glands and for characterizing some pathologic conditions. Our experience suggests that color Doppler sonography can provide additional diagnostic information in patients with chronic inflammatory diseases or suspected malignant tumors and can help in differentiating pleomorphic adenomas from other salivary gland tumors.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				F. Salaffi, M. Carotti, A. Iagnocco, F. Luccioli, R. Ramonda, E. Sabatini, M. De Nicola, M. Maggi, R. Priori, G. Valesini, et al. Ultrasonography of salivary glands in primary Sjogren's syndrome: a comparison with contrast sialography and scintigraphy Rheumatology, August 1, 2008; 47(8): 1244 - 1249. [Abstract] [Full Text] [PDF]

				E. J. Bialek, W. Jakubowski, P. Zajkowski, K. T. Szopinski, and A. Osmolski US of the major salivary glands: anatomy and spatial relationships, pathologic conditions, and pitfalls. RadioGraphics, May 1, 2006; 26(3): 745 - 763. [Abstract] [Full Text] [PDF]

				F Alyas, K Lewis, M Williams, A B Moody, K T Wong, A T Ahuja, and D C Howlett Diseases of the submandibular gland as demonstrated using high resolution ultrasound Br. J. Radiol., April 1, 2005; 78(928): 362 - 369. [Abstract] [Full Text] [PDF]

				K. Nakada, T. Ishibashi, T. Takei, K. Hirata, K. Shinohara, S. Katoh, S. Zhao, N. Tamaki, Y. Noguchi, and S. Noguchi Does Lemon Candy Decrease Salivary Gland Damage After Radioiodine Therapy for Thyroid Cancer? J. Nucl. Med., February 1, 2005; 46(2): 261 - 266. [Abstract] [Full Text] [PDF]

				E. J. Bialek, W. Jakubowski, and G. Karpinska Role of Ultrasonography in Diagnosis and Differentiation of Pleomorphic Adenomas: Work in Progress Arch Otolaryngol Head Neck Surg, September 1, 2003; 129(9): 929 - 933. [Abstract] [Full Text] [PDF]

				A. S. C. Ching and A. T. Ahuja High-Resolution Sonography of the Submandibular Space: Anatomy and Abnormalities Am. J. Roentgenol., September 1, 2002; 179(3): 703 - 708. [Full Text] [PDF]

				C. Martinoli, F. Giovagnorio, F. Pretolesi, and L. E. Derchi Identification of Feeding Arteries to Establish the Intra- or Extraparotid Location of Jugulodigastric Nodules: Value of Color Doppler Sonography Am. J. Roentgenol., November 1, 2000; 175(5): 1357 - 1360. [Abstract] [Full Text] [PDF]

				D. M. Yousem, M. A. Kraut, and A. A. Chalian Major Salivary Gland Imaging Radiology, July 1, 2000; 216(1): 19 - 29. [Abstract] [Full Text]