Value of Ultrasonography in the Diagnosis of Sialolithiasis of Submandibular Gland

Yoon, Dae Young; Choi, Moon Hae; Seo, Young Lan; Kim, Do Kyun; Lee, Sang Jo; Bae, Sang Hoon

Abstract

PURPOSE
To describe the normal sonographic anatomy of the submandibular duct and to assess the value of sonography in the diagnosis of sialolithiasis of the submandibular gland.
MATERIALS AND METHODS
Using continuous injection of saline via a sialography needle, we evaluated the normal sonographic anatomy of the submandibular duct in healthy volunteers (n=5). We also reviewed sonographic findings in 47 patients with (n=29) or without (n=18) stones. In each case, the presence or absence of stone was proved by sialography or surgery.
RESULTS
In control subjects, sonography accurately depicted the ductal anatomy of the submandibular glands and its relationship with adjacent tissues. For the detection of stones, sonography had a sensitivity of 86%, a specificity of 100%, and an accuracy of 91%. For ductal dilatation, its sensitivity was 91%, its specificity, 100%, and its accuracy, 94%. In 68% of cases with stones, a circumferential low echoic rim surrounding the stone ("rim sign") was present on sonogram.
CONCLUSION
Ultrasound is a useful procedure and could replace sialography in most patients with sialolithiasis of the submandibular gland.