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6.4.6: 6. Imaging

  • Page ID
    18327
  • A minority of submandibular tumours require imaging

    Indications

    • Suspected non-neoplastic disease e.g. sialadenitis, sialolithiasis (US / CT)
    • Distinguish between submandibular lymph node and salivary mass (US)
    • Reduced mobility/fixed tumour with invasion of surrounding structures (Panorex / CT / MRI)
    • Neurological deficits to determine extent of perineural invasion (MRI with Gd)
    • Malignant tumour (clinically / cytologically) to exclude cervical metastases (US / CT)
    • Exclude lung metastases with suspected/known malignancy (CXR / CT)

    Panorex: For adherence to mandible

    Ultrasound

    • Sialolithiasis / chronic sialadenitis / neoplasm
    • Cervical lymph nodes

    CT

    • Sialolithiasis / chronic sialadenitis / neoplasm
    • Cystic vs solid
    • Cervical lymph nodes
    • Advanced tumours: Erosion of mandible / invasion of muscles of floor of mouth / tongue

    MRI

    • Advanced tumours: Erosion of mandible / invasion of muscles of floor of mouth or tongue (Good soft tissue differentiation)
    • Perineural invasion

    PET-CT: Unhelpful as benign pathology (pleomorphic adenoma, infection), lymphoma are PET-avid