VISUALIZATION OF THE SALIVARY-GLANDS - CT AND MRI

For the evaluation of diseases of salivary origin, ultrasound and/or sialography is recommended instead of MRI. In cases of salivary tumor, ultrasound may be helpful in delineating superficial tumors. For small tumors no further imaging is needed. When dealing with a large tumor or a tumor in the deep lobe of the parotid gland, MRI is the preferred imaging method. Not only does MRI provide a large variety of soft tissue signal differences, but also the multiplanar facilities are helpful in delineating the extent of the tumor, whether located in the submandibular, sublingual, or parotid gland. Skull base invasion is often well seen by MRI. Subtle changes may be missed and in those cases CT is recommended to exclude or prove destruction of the skull base. For the evaluation of patients presenting with a recurrent pleomorphic adenoma, MRI is recommended in all patients. MRI delineates the extent and number of recurrent tumors better than palpation in most cases. No other imaging technique is as accurate in depicting recurrent pleomorphic adenomas as MRI at present. The use of an intravenous contrast medium remains controversial whether for primary or recurrent disease.