Salivary Glands
The salivary glands form a distinct anatomic and functional system. The spectrum of salivary gland disease varies greatly; although sometimes quite specific, salivary pathologies are often rare or of uncertain pathogenesis. Infection and inflammatory lesi
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Salivary Glands CHARLES RAFFAELLI, NICOLAS AMORETTI, BRUNO CAR LOTTI
CONTENTS 3.1 3.1.1 3.1.2 3.1.3 3.1.4 3.2 3.2.1 3.2.2 3.2.3 3.2.4 3.2.5 3.2.6 3.2.6.1 3.2.6.2 3.2.6.3 3.3 3.3.1 3.3.2 3.3.3 3.3.4 3.4 3.4.1 3.4.1.1 3.4.1.2 3.4.1.3 3.4.1.4 3.4.2 3.5 3.5.1 3.5.1.1 3.5.1.2 3.5.1.3 3.5.1.4 3.5.1.5 3.5.1.6 3.5.1.7 3.5.2
Anatomy 92 Parotid Gland 92 Submandibular Gland 93 Sublingual Gland 94 Accessory Salivary Glands 95 Sonographic Anatomy 95 Technical Modalities 95 Parotid Gland 95 Submandibular Gland 98 Sublingual Gland 100 Accessory Salivary Glands 101 Specific Techniques 101 Ultrasonic Tracking Systems and Three-dimensional Imaging 101 Stimulation of Saliva Secretion 101 US-guided Aspiration Biopsy 102 Other Imaging Modalities 103 Sialography 103 Scintigraphy 103 CT 103 MRI 103 Cysts and Malformations 104 Cystic Lesions 104 HIV-related Lymphoepithelial Cysts 104 Auriculobranchial Fistulas and Cysts 105 Salivary Cysts 106 Polycystic Disease of the Parotid 106 Malformations 107 Salivary Gland Tumors 107 Benign Tumors 107 Pleomorphic Adenoma 107 Basal Cell Adenoma 109 Oncocytoma 109 Papillary Cystadenolymphoma 109 Hemangioma and Lymphangioma 110 Lipoma 112 Neurogenic Tumors 112 Malignant Tumors 112
c:. RAFFAELLI, MD Service de Radiodiagnostic, H6pital Pasteur, 30, avenue Voie Romaine, BP 69, F-06002 Nice Cedex 1, France N. AMORETTI, MD Service de Radiodiagnostic, H6pital Pasteur, 30, avenue Voie Romaine, BP 69, F-06002 Nice Cedex 1, France Eo. CARLOTTI, MD Otorhinolaryngologiste, 88, boulevard de Cimiez, F-06000 Nice, France
3.5.2.1 3.5.2.2 3.5.2.3 3.5.2.4 3.5.2.5 3.5.2.6 3.5.3 3.5.3.1 3.5.3.2 3.5.3.3 3.5.3.4 3.6 3.6.1 3.6.2 3.6.3 3.7 3.7.1 3.7.2 3.7.2.1 3.7.2.2 3.8 3.8.1 3.8.2 3.8.3 3.9 3.9.1 3.9.2 3.9.3 3.10
Mucoepidermoid Carcinoma 113 Acinic Cell Tumor 114 Adenoid Cystic Carcinoma 115 Carcinoma 115 Lymphoma 116 Metastases 118 Role of Sonography in the Staging of Salivary Gland Tumors 118 Presumptive Determination of Origin Diagnosis of Malignancy 119 Etiological Diagnosis 120 Staging 122 Sialolithiasis 122 Submandibular Gland Lithiasis 123 Parotid Lithiasis 124 Extracorporeal Lithotripsy 125 Sialadenitis 125 Acute Sialadenitis 125 Chronic Sialadenitis 126 Chronic Recurrent Parotitis 126 Granulomatous Diseases 127 Sialosis 128 Sjogren's Syndrome 128 Salivary Calcinosis 129 Sialadenosis 129 Trauma 130 Gland Fractures and Injuries 130 Foreign Bodies 130 Pneumoparotitis 131 Post-therapeutic Features 131 References 133
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The salivary glands form a distinct anatomic and functional system. The spectrum of salivary gland disease varies greatly; although sometimes quite specific, salivary pathologies are often rare or of uncertain pathogenesis. Infection and inflammatory lesions predominate, but a wide variety of tumors are also encountered. Technological progress in sonography has made this noninvasive procedure with multiple operating modes the initial imaging technique of choice for the salivary glands. Owing to the superficial location of these glands, high-frequency ultrasound (US) transducers provide markedly
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