title: Comparison of the sonographic features of acalculous and calculous submandibular sialadenitis.
abstract: OBJECTIVE
  The purpose of this study was to compare the sonographic features of acalculous and calculous sialadenitis of the submandibular gland.
  
  
  METHODS
  A retrospective review of sonograms of the neck was performed in 25 patients with submandibular sialadenitis: 8 with acalculous and 17 with calculous disease. The submandibular glands were assessed for size, shape, border, and echogenicity; presence of dilated ducts or other intraglandular lesions; inflammatory changes in adjacent tissues; lymphadenopathy; and involvement of other salivary glands.
  
  
  RESULTS
  In the group with acalculous sialadenitis, 4 (50%) of the 8 patients had unilateral disease, and 11 (92%) of 12 glands were rounded. In all cases (100%), multiple hypoechoic lesions were diffusely distributed throughout the submandibular glands against a heterogeneous parenchymal background. The lesions ranged from 3 to 15 mm and were oval or round. Confluent lesions were noted in 2 glands (17%). There was no sonographic evidence of duct dilatation, calculi, or abnormal lymph nodes. All patients with calculous sialadenitis had unilateral disease; 9 had a main duct calculus (53%), 7 had intraglandular calculi (41%), and 1 had both (6%). In 14 (82%) of 17 glands, normal shape was maintained, and 11 (65%) of 17 had duct dilatation.
  
  
  CONCLUSIONS
  Acalculous submandibular sialadenitis differs from the calculous form of the disease. The former has characteristic sonographic features, including a round gland with numerous hypoechoic lesions in a heterogeneous parenchymal background. Sonographic imaging in conjunction with fine-needle aspiration is useful for detection of this disorder.
authors: Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong.
authors: A S
authors: AS
authors: Ching
authors: A T
authors: AT
authors: Ahuja
authors: A D
authors: AD
authors: King
authors: G M
authors: GM
authors: Tse
authors: C
authors: C
authors: Metreweli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015494:Salivary Gland Calculi / Q000000981:diagnostic imaging* / Q000473:pathology; D013364:Submandibular Gland Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods