The MR Imaging Assessment of Submandibular Gland Sialoadenitis Secondary to Sialolithiasis: Correlation with CT and Histopathologic Findings
Misa Sumia,
Masahiro Izumia,
Koichi Yonetsua and
Takashi Nakamura
,a
a From the Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, Nagasaki, Japan.
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FIG 1. 68-year-old woman with left submandibular sialolith.
A, CT shows sialolith (arrow) in hilum of the gland.
B, T1-weighted MR image (530/17/2 [TR/TE/excitations]) of affected submandibular gland (arrow) shows lower signal intensity compared with normal gland on right side.
C, Fat-suppressed T2-weighted MR image (3200/96/2 [TR/TE/excitations]) of affected submandibular gland (arrow) shows higher signal intensity than control gland (right side).
D, STIR image (2000/14/160/2 [TR/TE/inversion time/excitations]) of affected gland (arrow) shows higher signal intensity compared with normal gland on right side.
E, Photomicrograph of excised gland shows extensive infiltration of inflammatory mononuclear cells associated with destruction of gland structures and mild fibrosis. (Hematoxylin & eosin stain, original magnification, x200)
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FIG 2. 18-year-old man shows concomitant involvement of sublingual and submandibular glands.
A, CT shows sialolith (arrow) near orifice of main duct.
B and C, Fat-suppressed T2-weighted (3200/96/2 [TR/TE/excitations]) and STIR MR (2000/14/160/2 [TR/TE/inversion time/excitations]) images show increased signal intensity of left sublingual gland (arrows).
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FIG 3. Recovery of affected submandibular gland after surgical removal of sialolith.
A and B, Fat-suppressed T2-weighted images (3000/96/2 [TR/TE/exciations]) of 33-year-old woman show that the signal intensity level of the left submandibular gland (arrow) has returned to that of the normal gland (right side) 4 months after surgical removal of sialolith. A, before surgery; B, after surgery.
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FIG 4. 50-year-old man with left submandibular sialolith.
A, CT shows sialolith (arrow) in proximal one third of main duct. Affected gland is atrophic.
B, T1-weighted MR image (500/14/2 [TR/TE/excitations]) of affected gland (arrow) shows higher signal intensity compared with gland on right side.
C, Fat-suppressed T2-weighted MR image (3000/96/2 [TR/TE/excitations]) shows lower signal intensity compared with normal right side.
D, Photomicrograph of excised gland shows extensive fat replacement of gland tissues. Original magnification, x200.
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FIG 5. 15-year-old girl with right submandibular sialolith.
A, CT shows sialolith (arrow) in proximal one third of main duct.
B, C, and D, T1-weighted (530/17/2 [TR/TE/excitations])(B), fat-suppressed T2-weighted (3200/96/2 [TR/TE/excitations]) (C), and STIR (2000/14/160/2 [TR/TE/inversion time/exciations])(D) MR images show no apparent difference between affected (arrow) and normal glands (left side).
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FIG 6. 64-year-old man shows abscess formation in the extraglandular space.
A, Enhanced CT shows abscess formation around a large sialolith (arrow) in right floor of the mouth, demarcated by a slightly enhanced, broad rim (arrow heads). It was confirmed at surgery thas this sialolith was penetrating the duct wall.
B, T2-weighted MR image (3000/96/2 [TR/TE/excitations]) shows extension of inflammation in the floor of the mouth, beyond affected gland involving right sublingual gland (arrow).
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