title: [Use of state-of-the-art ultrasound techniques in diagnosing sarcoidosis of the salivary glands (Heerfordt's syndrome)].
abstract: OBJECTIVE
  The parotid gland is a rare site of sarcoidosis (6% of all cases). The role of state-of-the-art ultrasound techniques in the diagnostic assessment of parotid sarcoidosis (Heerfordt's syndrome) is presented.
  
  
  METHODS
  Four patients (three male, one female; aged 31-42 years) with inconclusive parotid swelling associated with fever and uveitis were referred for diagnostic assessment by the ENT outpatient service over a 1 year period. High-resolution ultrasound (US) was performed using the SONOLINE Elegra system with a 7.5-MHz wide-band transducer and various, special US techniques (tissue harmonic imaging, photopic imaging, color-coded duplex US, and power Doppler). Diagnoses were confirmed in all cases by puncture and histology.
  
  
  RESULTS
  Two patients with typical lung findings (stage I and II sarcoidosis) and two patients without known sarcoidosis showed an inhomogeneous nodular appearance of the clinically enlarged salivary glands at US. Duplex US demonstrated hypervascularization in three cases and moderate, inhomogeneous vascularization in one. In comparison to plain B-mode scanning, optimal visualization of the hypodense, nodular, structural changes was achieved using contrast-enhancing techniques. All patients underwent US-guided puncture for determining the etiology of parotitis. Histology demonstrated granulomatous epitheloid cell inflammation.
  
  
  CONCLUSIONS
  An inhomogeneous nodular appearance of the parenchyma of enlarged parotid glands with areas of hypervascularization, which is optimally depicted by state-of-the-art US techniques, should suggest Heerfordt's syndrome as a possible differential diagnosis.
authors.affiliation: Institut für Radiologie, Universitätsklinikum Charité, Humboldt-Universität zu Berlin. thom.fischer@charite.de
authors.forename: T
authors.initials: T
authors.lastname: Fischer
authors.forename: M
authors.initials: M
authors.lastname: Mühler
authors.forename: D
authors.initials: D
authors.lastname: Beyersdorff
authors.forename: H
authors.initials: H
authors.lastname: Guski
authors.forename: M
authors.initials: M
authors.lastname: Bollow
authors.forename: B
authors.initials: B
authors.lastname: Hamm
authors.forename: M
authors.initials: M
authors.lastname: Werbs
authors.forename: S
authors.initials: S
authors.lastname: Filimonow
mesh_terms: D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D004867:Equipment Design; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000295:instrumentation; D008297:Male; D010305:Parotid Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D010306:Parotid Gland / Q000000981:diagnostic imaging / Q000473:pathology; D012507:Sarcoidosis / Q000000981:diagnostic imaging* / Q000473:pathology; D017565:Sarcoidosis, Pulmonary / Q000000981:diagnostic imaging / Q000473:pathology; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color / Q000295:instrumentation*; D018616:Ultrasonography, Doppler, Duplex / Q000295:instrumentation*; D017585:Ultrasonography, Doppler, Transcranial / Q000295:instrumentation