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Overview of imaging techniques for salivary glands.
Exploratory methods of salivary glands

1. X-rays without preparation.

radiographie radiographie Plainfilm

The views of the salivary glands are taken full face and profile of the parotid, or the submandibular gland, depending on the pathology. A 3/4 x-ray view of the submandibular gland is preferred.

These different x-rays can show not only radio opaque stones in the salivary glands, but also old calcifications in a lymph node.

2. Regular occlusal x-rays of the floor of the mouth.

These occlusal views are helpful in revealing an opaque stone in the submandibular gland, or in the duct.
The procedure entails actually putting film in the mouth to obtain an x-ray image.
Regular occlusal X-rays can only be made at the sub-mandibular and sub-lingual glands levels. They either entail the positioning of an occlusal image source in an orthogonal position in relation to the mouth's floor, or scanning the ray to obtain a view of the forward sub-mandibular gland.
This results in the visualisation of calcification in the glandular area. These are most frequently stones but may also be calcified lymph node.

3. Sialography

Technique

A cannula is introduced into the parotid or submandibular ducts and is used to inject contrast enhancing products (eg Lipiodol) to outline the ramifications of the ductal systems of these glands, showing their patterns and calibers. This examination can be performed on everyone, including children over the age of 4. The injection should be of no more than 0.5 to 1 cc, and injected very slowly. This examination is painless if done smoothly. The only contraindication is an allergic reaction to iodine.It must be know in such cases, pre-medication with corticosteroïds will permit the examination.

Results

sialograhie sialographie

sialographie sialographie sialographie sialographie sialographie

Basically, sialography is prescribed each time there is a suspicion of an inflammatory syndrome, especially if there is the possibility of a lithiasis,
in order to visualize the exact caliber of the duct and the position of the stone, as opposed to calcification within a lymph node.

4. Echography - Ultrasound imaging of salivary glands.

Ultrasound imaging of salivary glands has become a standard technique for the last 10 years. It allows for a diagnostic approach, and technological progress make it an essential diagnotic tool. The procedure is fast, pain free, and can therefore be very easy to perform with children.
echographie echographie
echographie echographie
echographie
Technical overview

For this examination, we use a 7,5 MHz high frequency transductor or, better yet, a real time 6 to 15 MHz digital multifrequencies transductor in order to visualize the vascularisation of the salivary gland in the event of the presence of an inflammatory syndrome.

This technological advance enables an analysis of the most minute superficial structures within the neck. 10 years ago, only pathological ganglions were visible, i.e., whose diameter was superior to 1cm. It is now possible to view perfectly normal lymph nodes ranging from 2 to 5 mm in diameter.
On the other hand, with color, pulsed or energy dopplers it is possible to look for increased vascularisation that is typical of a tumor, or of a ganglion's inflammatory process.
Results

With echography, lithiasis imaging is always hyperechogenic, they are in the most frequent cases, enclosed in a hypoechogenic halo representing the dilation of the duct containing the stone. Computer assisted imaging allows for the identification of stones with a diameter as small as 0.5mm.
The E.E.D. Energy Doppler provides excellent results as to the assessment of the degree of glandular parenchymal inflammation.