Bilateral parotid swelling: a radiological review.

Bilateral parotid swelling is not an uncommon occurrence and may pose a challenge for clinicians and radiologists. Numerous causes of bilateral parotid swellings have been identified. The purpose of this pictorial review is to display this wide array with a focus on multimodality approach.

MR sialography of iatrogenic sialocele: comparison with conventional sialography.

OBJECTIVE: The objective of this study was to compare the conventional sialography with MR sialography in a series of patients with iatrogenic sialocele (sialocyst). METHODS: 50 salivary glands in 39 patients with suspected inflammatory disease of the salivary gland underwent conventional sialography and MR sialography. Out of these 39 patients, 6 patients (age range: 16-35 years; 4 males and 2 females; mean age: 23.8 years) had sialoceles and formed our study group. MR sialography findings were compared with conventional sialography findings regarding demonstration of ductal anatomy, the cyst and its communication with the ductal system. RESULTS: MR sialography demonstrated the site of communication of the sialocyst with the ductal system in all six patients. MR provided additional information over conventional sialography in five cases. In four cases, the ductal system proximal to the cyst was not opacified on digital sialography but was well visualized in all cases by MR sialography. Constructive interference in steady-state (CISS) sequence demonstrated the intraglandular ducts and communication of cysts with ducts better than half-fourier acquisition single-shot turbo-spin echo (HASTE) images. CONCLUSION: Our preliminary results suggest that MR sialography is a robust, non-invasive method for demonstrating the ductal system up to second-order branches, the site of ductal injury and the focal cystic lesion. MR provided at least the same information as conventional sialography in the evaluation of site of communication but provided additional information about the sialocyst and upstream ductal system in five cases. Being a non-invasive modality, we recommend MR sialography as the investigation of choice in the evaluation of an iatrogenic sialocyst.

Case report: Antenatal MRI diagnosis of cloacal dysgenesis syndrome.

Cloacal dysgenesis sequence (CDS) is a lethal malformation with a highly variable presentation. CDS is characterized by direct communication between the gastrointestinal, urinary, and genital structures, resulting in a single perineal opening. Prenatal diagnosis of a cloacal anomaly is often difficult because of the highly variable imaging features. Here, we report a case in which a diagnosis of CDS was made with fetal MRI on the basis of a meconium-containing, bilobed, abdominopelvic cystic mass communicating with the ureters and the colon.

Multidetector computed tomography of jaw lesions in children and adolescents.

Jaw lesions in paediatric and adolescent population are uncommon and can arise in odontogenic or non-odontogenic tissues. With the advent of multidetector computed tomography (MDCT), algorithm for imaging jaw lesions has changed dramatically. This pictorial essay describes the imaging appearance of commonly encountered jaw lesions in children and adolescents with emphasis on MDCT findings.

Antenatal Sonography and MRI of Iniencephaly apertus and clausus.

Iniencephaly is a lethal and an extremely rare neural tube defect. It is characterized by fixed retroflection of the head, cervical dysraphism and occipital bone defect. Associated anomalies of the nervous and other systems are frequently present. Most cases are diagnosed prenatally by ultrasound. We report prenatal ultrasonographic, fetal MRI and pathological findings of 2 cases of iniencephaly (one each of iniencephaly apertus and clausus).

Imaging findings of congenital tuberculosis in three infants.

Congenital tuberculosis is a rare entity and diagnosis is usually delayed due to the nonspecific nature of the signs and symptoms. Imaging studies facilitate the early diagnosis of the disease and institution of appropriate therapy. We describe three cases of congenital tuberculosis along with the imaging features. Imaging findings of the chest included multiple pulmonary nodules, consolidation with cavitation, extensive bronchopneumonia and necrotic mediastinal adenopathy. Abdominal imaging findings included hepatomegaly with or without splenomegaly, multiple focal lesions in the spleen and retroperitoneal lymphadenopathy.

Radiographical approach to jaw lesions.

Many lesions that occur in the jaw have a similar radiographical appearance and it is often difficult to differentiate among them. Despite development of various cross-sectional imaging modalities, the radiograph still remains the first and the most important investigation. Radiographical evaluation of jaw lesion characteristics, which include location, margin, density, relation to tooth, along with knowledge of the clinical data, generally helps in narrowing the differential diagnosis.

Congenital salivary fistula of accessory parotid gland: imaging findings.

UNLABELLED: We report the imaging findings in a rare case of an accessory parotid gland fistula. MATERIAL AND METHODS: An eight-year-old boy was presented with complaints of serous discharge from his left cheek since birth. As part of the radiological investigation, magnetic resonance imaging, computed tomography sialography with fistulography, and digital sialography with fistulography were performed. RESULTS: Magnetic resonance imaging demonstrated the exact location of an accessory parotid gland but failed to demonstrate the accessory duct. The presence of an accessory gland was well delineated on computed tomography fistulography and computed tomography sialography. Fistulography revealed a small accessory parotid duct and gland. No communication between the ductal systems of both glands was demonstrated. CONCLUSIONS: In such cases, pre-operative imaging (with sialography, magnetic resonance sialography and computed tomography sialography with fistulography) is helpful for exact delineation of the ductal anatomy. To the best of our knowledge, only four previous cases of congenital accessory parotid gland fistula have been reported in the English literature.

Non-familial cherubism.

Cherubism is a disease that usually affects the jaws in the paediatric population, mostly below five years of age. Radiologically, it closely resembles fibrous dysplasia and other giant cell lesions of the mandible. Computed tomography (CT) is helpful in defining the true extent of cherubic lesions, which is often not possible on radiographs due to the overlapping facial bones. We describe the radiographical and CT features of cherubism in a 12-year-old boy and highlight the ability of multidetector CT and various post-processing techniques to accurately depict the anatomical extent of the cherubic lesions.

Magnetic resonance identification of an accessory submandibular duct and gland: an unusual variant.

UNLABELLED: We report a case of an accessory submandibular gland and duct which is extremely rare. MATERIAL AND METHODS: A 20-year-old male presented with complaints of painful swelling in the right submandibular region. As a part of the radiological investigation, a radiograph occlusal view was taken digital sialography, magnetic resonance imaging and magnetic resonance sialography were performed. RESULTS: Digital sialography revealed a small calculus distal to the punctum with diffuse dilatation of the main duct and intraglandular branches, which passed out spontaneously prior to magnetic resonance examination. The presence of an accessory submandibular duct was well delineated on both digital as well as magnetic resonance sialography. CONCLUSIONS: Magnetic resonance sialography is helpful in delineating the anatomy of the submandibular duct non-invasively and without associated radiation exposure. To the best of our knowledge this is the first report of magnetic resonance identifying an accessory submandibular duct and gland.