Obstructed parotid duct: MR sialogram

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Long standing left facial pain, worse with eating meals

Patient Data

Age: 35
Gender: Male
Axial T2
fat sat
Sagittal
T2 fat sat
This study is a stack
Coronal T2
fat sat
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Info

Dilated left parotid duct from the gland extending up to the left cheek where there is a tapered narrowing. Note the asymmetry when compared with the right (arrows). Note also the dilated accessory duct entering the main duct (best seen on the sagittal imaging)

ultrasound
Transverse
colour
Doppler
Transverse
Transverse
Transverse
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Info

US confirms the MRI findings and shows minor increase in vascularity in the gland parenchyma.  No intra-luminal calculus at the distal end of the duct in the cheek.

Case Discussion

Catheter sialography is fiddly and uncomfortable for the patient.  MR sialography is a useful alternative especially if the ducts are dilated

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