Identification of feeding arteries to establish the intra- or extraparotid location of jugulodigastric nodules: value of color Doppler sonography.
OBJECTIVE
The objective of our study was to determine the value of color Doppler imaging as an adjunct to gray-scale sonography to reveal the intra- or extraparotid origin of jugulodigastric nodules of uncertain location.


METHODS
Forty nodules in the jugulodigastric area from 38 patients were imaged with gray-scale, color, and power Doppler sonography. Nodules receiving vessels from salivary glands were assumed to be intraglandular; those accepting vessels from paraparotid spaces were considered to arise from outside the gland. Imaging results were correlated with biopsy and surgical findings.


RESULTS
In 38 of 40 cases, color and power Doppler sonography displayed discrete feeding arteries leading to the nodules: 25 nodules had one supplying artery, nine received two arteries, and four had three or more arteries. Intraparotid nodules received vessels from the gland in 20 cases. In two cases, the source of vessels was indeterminate. In two malignant tumors, multiple arteries derived from both the parotid and the neck spaces. All 14 extraparotid nodules received the arterial supply from paraparotid spaces. Color Doppler sonography enabled prediction of the intraglandular location of the nodules in 91% of cases and the extraglandular location in 87.5% of cases. The correct diagnosis was achieved in 34 of 40 nodules, with a global accuracy of 85%.


CONCLUSIONS
Color Doppler sonography can help to assess the intra- or extraparotid location of jugulodigastric nodules. In practice, this technique can support the diagnosis when gray-scale sonography raises doubts about the origin of a jugulodigastric nodule.
Martinoli
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Cattedra "R" di Radiologia, DICMI, Università di Genova, Largo Rosanna Benzi 8, 1-16132 Genova, Italy.
Giovagnorio
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Pretolesi
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F
Derchi
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LE
D000235:Adenolymphoma / Q000098:blood supply / Q000000981:diagnostic imaging; D008949:Adenoma, Pleomorphic / Q000098:blood supply / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000000981:diagnostic imaging; D001706:Biopsy; D002277:Carcinoma / Q000098:blood supply / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D005544:Forecasting; D006258:Head and Neck Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000098:blood supply / Q000000981:diagnostic imaging; D010307:Parotid Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging; D013363:Submandibular Gland / Q000098:blood supply / Q000000981:diagnostic imaging; D013365:Submandibular Gland Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler; D018615:Ultrasonography, Doppler, Color