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The role of MRI in facial swelling due to presumed salivary gland disease

R F J Browne, MBBCh, BAO, MSc,1, S J Golding, MA, FRCR1 and S R Watt-Smith, MD, FDSRCS2

1 Department of Radiology, University of Oxford
2 Department of Oral Surgery, John Radcliffe Hospital, Headington, Oxford, UK



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  		Figure 1. Intrinsic parotid tumour. (a) Coronal T1 weighted spin echo image shows a well defined, low signal intensity lesion confined to the superficial lobe of the right parotid gland. (b) Axial T2 weighted high resolution image with fat suppression shows high signal intensity and confirms the site of the mass in the superficial lobe. Superficial parotidectomy showed a pleomorphic adenoma.

 


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  		Figure 2. Extrinsic neoplasm. The patient presented with swelling around the left submandibular gland. Axial T2 weighted image shows multiple extrinsic masses (arrows) with smaller lesions contralaterally. Biopsy showed non Hodgkin's lymphoma.

 


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  		Figure 3. Reactive lymphadenopathy. Patient presented with right facial swelling. MRI showed multiple, mildly enlarged lymph nodes on the right and also contralaterally (arrows) and in the jugular groups. Symptoms settled on conservative management.

 


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  		Figure 4. Axial high resolution T2 weighted images showing (a) dilated intraglandular ductules and (b) a short segment of dilated proximal main duct in a patient with persistent right facial swelling. Superficial parotidectomy carried out on symptomatic grounds confirmed chronic sialadenitis.

 


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  		Figure 5. High resolution T2 weighted image showing intraglandular main duct dilatation proximal to a well defined signal void (arrow), which was also shown on T1 weighted images. Sialography confirmed duct obstruction due to calculus at this point.

 


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  		Figure 6. Fatty infiltration of both parotid glands. T2 weighted image showing uniform enlargement of both glands, with no evidence of duct dilatation and signal intensity comparable with that of fat.

 




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