Comparison of the sonographic features of acalculous sand calculous submandibular sialadenitis

Objective. The purpose of this study was to compare the sonographic feature s of acalculous and calculous sialadenitis of the submandibular gland. Methods. A retrospective review of sonograms of the neck was performed in 2 5 patients with submandibular sialadenitis: 8 with acalculous and 17 with c alculous disease. The submandibular glands were assessed for size, shape, b order, and echogenicity; presence of dilated ducts or other intraglandular lesions; inflammatory changes in adjacent tissues; lymphadenopathy; and inv olvement of other salivary glands. Results, in the group with acalculous sialadenitis, 4 (50%) of the 8 patien ts had unilateral disease, and 11 (92%) of 52 glands were rounded. In all c ases (100%), multiple hypoechoic lesions were diffusely distributed through out the submandibular glands against a heterogeneous parenchyma[ background . The lesions ranged fram: 3 to 15 mm and were oval or round. Confluent les ions were noted in 2 glands (17%). There was no sonographic evidence of duc t dilatation, calculi, or abnormal lymph nodes. All patients with calculous sialadenitis had unilateral disease; 9 had a main duct calculus (53%), 7 h ad intraglandular calculi (41%), and 1 had both (6%). In 14 (82%) of 17 gla nds, normal shape was maintained, and 11 (65%) of 17 had duct dilatation. Conclusions. Acalculous submandibular sialadenitis differs from the calculo us form of the disease. The former has characteristic sonographic features, including a round gland with numerous hypoechoic lesions in a heterogeneou s parenchymal background. Sonographic imaging in conjunction with fine-need le aspiration is useful for detection of this disorder. (C) 2001 John Wiley & Sons, Inc.