Role of high resolution ultrasound in parotid lesions in children.

PURPOSE: A pictorial review of the spectrum of sonographic abnormalities of the parotid gland in children is presented.

METHODS: Two pediatric radiologists performed retrospective review of medical records and imaging findings of all parotid ultrasounds performed in 298 children in the age range of 24 days to 16 years, over a five-year period.

RESULTS: The lesions varied from diffuse glandular abnormalities to discrete solid and cystic lesions. Of the 298 studies reviewed, 148 (49.6%) were normal results, while 150 (50.4%) had abnormalities of parotid gland identified at ultrasonography. These included acute parotitis in 54 (36%) cases, recurrent parotitis in 12 (8%), and intra-parotid abscess in 12 (8%) cases. Among the tumors, haemangioma was the commonest, identified in 16 (10.6%) cases, followed by lymphatic malformation in 3 (2%), Hodgkin's disease 2 (1.3%) and pleomorphic adenoma (1 case). Sialadenosis was identified in 4 (2.6%) cases. Abnormality of the superficial soft tissues was also seen in 25 cases. 12 cases had a lymphatic malformation of the neck, involving the parotid, while 11 cases had a vascular lesion of the cheek, but not involving the parotids directly.

CONCLUSION: High resolution ultrasound remains the first-line imaging modality for evaluation of the parotid gland. It is sensitive in detection of salivary gland abnormalities.