Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · May 2018
ReviewImaging of Sjögren Syndrome and Immunoglobulin G4-Related Disease of the Salivary Glands.
The salivary glands are commonly affected in systemic autoimmune disease and diseases of unknown pathogenesis. Sjögren syndrome (SjS) can be affected by other systemic diseases. Immunoglobulin G4-related disease (IgG4-RD) commonly affects salivary glands. ⋯ Findings of early-stage SjS are difficult to identify on routine computed tomography or MR imaging. Chronic SjS can be diagnosed from MR imaging and sialographic findings. Multiglandular and localized involvement of IgG4-RD is difficult to differentiate from malignant lymphoma for multiglandular disease and salivary gland carcinoma for localized disease.
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MR imaging is the modality of choice in evaluation of salivary gland tumors. Postcontrast MR imaging is adequate for exact localization and extension of salivary gland tumors and multiparametric of diffusion-weighted and dynamic contrast-enhanced MR imaging helps in characterization of benign and malignant salivary gland tumors. Imaging is important for preoperative localization, characterization of salivary gland tumors and locoregional extension, perineural spread, and nodal and distant staging of malignant salivary gland tumors. Imaging has a role in detection of tumor recurrence, monitoring patients after therapy, prediction of malignant transformation of benign tumors, and differentiation of salivary gland tumors from simulating inflammatory and autoimmune disorders.
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Salivary gland diseases in children are uncommon, and the relative incidence of pathologies is different than in adults. This article presents a comprehensive review of congenital and acquired disorders that affect the major salivary glands in the pediatric population, highlighting the imaging findings that are important in defining the appropriate diagnosis or narrowing of the differential diagnosis.
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Neoplastic and non-neoplastic lesions may involve the minor salivary glands. Tumors of minor salivary glands are commonly seen in the oral cavity. ⋯ Non-neoplastic lesions may involve minor salivary glands such as Sjogrene disease, immunoglobulin G4-related disease, necrotizing sialometaplasia, and subacute necrotizing sialadenitis. Contrast MR imaging and computed tomography are adequate for localization and extension of neoplastic and non-neoplastic lesions of minor salivary glands.
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The aim of this study is to review the imaging appearance of posttreatment salivary gland tumors. The authors discuss the imaging appearance of parotidectomy and reconstructive surgery of parotid defects. Imaging is important to diagnose tumor recurrence and also assess for complications related to surgery, such as a sialocele, fluid collection, hematoma, pseudoaneurysm, and graft stenosis. The article also provides a current-state assessment of the applications of advanced imaging techniques.