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(Radiographics. 2001;21:1211-1227.)
© RSNA, 2001

Education Exhibit

Swelling at the Angle of the Mandible: Imaging of the Pediatric Parotid Gland and Periparotid Region1

Lisa H. Lowe, MD, Leanne S. Stokes, MD, Joyce E. Johnson, MD, Richard M. Heller, MD, Stuart A. Royal, MD, Curt Wushensky, MD and Marta Hernanz-Schulman, MD

1 From the Department of Radiology, Children’s Mercy Hospital, University of Missouri–Kansas City, 2401 Gillham Rd, Kansas City, MO 64108 (L.H.L.); the Departments of Radiology and Radiological Sciences (L.S.S., R.M.H., C.W., M.H.S.) and Pathology (J.E.J.), Vanderbilt Children’s Hospital, Nashville, Tenn; and the Department of Radiology, Children’s Hospital of Alabama, Birmingham (S.A.R.). Presented as an education exhibit at the 2000 RSNA scientific assembly. Received February 27, 2001; revision requested March 21 and received May 11; accepted May 14. Address correspondence to L.H.L. (e-mail: llowe@cmh.edu).

The pediatric parotid gland and periparotid region are subject to a variety of lesions and are most often evaluated with ultrasonography (US), contrast material–enhanced computed tomography (CT), and magnetic resonance (MR) imaging. US may be used to assess the size of the parotid gland, distinguish diffuse from focal disease, assess vascularity and adjacent vascular structures, distinguish cystic from solid lesions, and guide fine-needle aspiration. However, further evaluation with CT or MR imaging may be needed to better define the nature and extent of disease. CT is the imaging modality of choice for most pediatric parotid disease (including acute inflammation, abscess, calculi, and major salivary duct obstruction) and most solid masses and may obviate sedation. However, a mass associated with facial nerve symptoms should be evaluated with MR imaging because it is the only modality that can consistently demonstrate the facial nerve. Findings at US, CT, and MR imaging allow localization of parotid lesions and may suggest a specific cause. Clinical information, familiarity with normal parotid anatomy at various stages of its development, and knowledge of the imaging characteristics of parotid and periparotid lesions are essential for appropriate radiologic evaluation. This information can be used to guide therapy and plan a surgical approach.

Index Terms: Branchial cleft, 2641.1471 • Parotid gland, 2641.20, 2641.219, 2641.22, 2641.23, 2641.242, 2641.696, 2641.92 • Parotid gland, neoplasms, 2641.34, 2641.36, 2641.37 • Radiography, in infants and children, 2641.1211, 2641.1214, 2641.1298






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