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Parotid Sialodocholithiasis and Sialectasia on MRI

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Here is another MR scan of a

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patient who is suspected of having

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left parotid sialodocholithiasis.

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We're going to start from below and scroll upward.

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So here we are at the angle of the mandible,

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the tail of the parotid gland.

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We come upward and we see all this enlarged ductal

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pattern that is not present on the contralateral side.

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On the contralateral side,

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we do see the prominence of the

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venous system here and then the ductal system

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coming towards the second mandibular,

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second maxillary molar region. However,

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within the left gland,

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you see much larger ductal system,

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more acinar pattern,

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and you actually are able to see a calculus within

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the proximal portion of Stensen's duct.

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You may also wonder here about

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whether or not there is some sludge.

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Some sludge here.

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Calcified sludge within the opening to the buccinator

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muscle of Stensen's duct on the left side.

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So this would be MR evidence of calculi in the ducts,

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as well as probably a focal calcification

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here within the gland seen here.

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It doesn't look like a venous structure.

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It looks like a calcification with

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the ductal system being dilated.

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This is kind of a chronic sialadenitis appearance to the

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ductal system with areas of narrowing and

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widening analogous to, for example,

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fibromuscular dysplasia in the blood vessels.

Report

Description

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Tags

Salivary Glands

Neuroradiology

Metabolic

MRI

Head and Neck

Acquired/Developmental

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