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Abstract
SUMMARY AND CONCLUSION
The present study was carried out at the Radiodiagnosis Department, Zagazig University Hospitals. The present study included 30 patients; 21 females and 9 males. Their ages ranged between 20 to 75 years with the mean age 40.6 years.
The patients were referred from General Surgery and Internal Medicine Departments.
Swelling at the region of the salivary gland present in all patients followed by pain and tenderness in 16 patients, colicky postprandial swelling in 10 patients , weight loss in 5 patients, fever in 3 patients, skin ulceration and facial nerve manifestations in 2 patients.
The patients were selected on the basis of clinical examination, and underwent US, CT examinations. Histopathological examination were done in neoplastic cases.
The patients were categorized according to the cause of the swelling into: 14 patients with sialolithiasis, 6 patients with sialadenitis , 5 patients with pleomorphic adenoma, 2 patients with mucoepidermoid carcinoma, 2 patients with metastasis and 1 patient with lymphoma.
CT was able to detect the salivary stones and was superior than US in distinguishing multiple clusters of stones from single large stones . US was superior than CT in detection of duct dilatation especially the subtle dilatation proximal to the stone.
CT was superior than US in the detection of small abscess . Moreover CT might be helpful for evaluation of infiltration of subcutaneous tissues and extent of the lesion.
In neoplastic cases CT was superior to US in detection of the size of larger masses, tumor extension, calcification as well staging.
In conclusion:
1) Evaluation of a patient with salivary swelling begins with clinical assessment.
2) If the swelling is painfull, US is done.
3) If US reveled sialolithisis but the site is not clear, CT without contrast is done.
4) If the swelling is pailness, US is done and it may reveal cystic or solid lesion.
5) CT is done on solid lesions for studying morphology of the lesion, extension of it and staging
The following pathway is recommended