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Identification of Feeding Arteries to Establish the Intra- or Extraparotid Location of Jugulodigastric Nodules

Value of Color Doppler Sonography

Carlo Martinoli1, Francesco Giovagnorio2, Fabio Pretolesi1 and Lorenzo E. Derchi1

1 Cattedra "R" di Radiologia, DICMI, Università di Genova, Largo Rosanna Benzi 8, 1-16132 Genova, Italy.
2 Cattedra di Radiologia, Università "La Sapienza," Policlinico Umberto I. Viale Regina Elena 324, 1-00161 Roma, Italy.



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  		Fig. 1. —Diagram illustrates how color Doppler sonography assessed intraparotid location of nodules on basis of their arterial supply coming from gland.

 


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  		Fig. 2. —Diagram explains how color Doppler sonography assessed extraparotid location of nodules on basis of their arterial supply derived from paraparotid spaces.

 


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  		Fig. 3. —69-year-old man with solid hypoechoic nodule (N) close to lower pole of left parotid gland (P). Color Doppler sonogram shows single arterial supply (arrow) leading to nodule from inside gland. Cytology (not shown) revealed pleomorphic adenoma.

 


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  		Fig. 4. —45-year-old woman with solid hypoechoic nodule (N) close to left parotid gland, somewhat similar to nodule described in Figure 3. Color Doppler sonogram shows nodule receiving vessels (arrow) from extraparotid spaces. Diagnosis was reactive lymph node. Asterisk = external carotid artery, P = parotid gland.

 


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  		Fig. 5A. —43-year-old woman with 5-mm cystic nodule in jugulodigastric area. Gray-scale sonogram shows nodule (arrows) to be close to submandibular gland (S).

 


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  		Fig. 5B. —43-year-old woman with 5-mm cystic nodule in jugulodigastric area. Color Doppler (B) and power Doppler (C) sonograms show discrete feeding artery (arrow) proceeding toward nodule from inside submandibular gland. Needle aspirate (not shown) revealed Warthin's tumor.

 


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  		Fig. 5C. —43-year-old woman with 5-mm cystic nodule in jugulodigastric area. Color Doppler (B) and power Doppler (C) sonograms show discrete feeding artery (arrow) proceeding toward nodule from inside submandibular gland. Needle aspirate (not shown) revealed Warthin's tumor.

 

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