Department of Radiology, College of Medicine, Ewha Womans University.
Published online: January 1, 2001.
ABSTRACT
PURPOSE: To evaluate the sonographic features and assess the diagnostic value of ultrasonography in recurrent parotitis during childhood which is characterized by intermittent, unilateral or bilateral painful swellings of the parotid glands. MATERIALS AND METHODS: Ten children(5 boys and 5 girls, ages between 2-14yrs), who complained for more than two times of painful swellings in the parotid gland without underlying systemic diseases, were studied by a high resolution ultrasound with 7MHz linear transducer. The parotid glands (n=20) were evaluated in their size, parenchymal echogenicity and vascular signals on the color Doppler study. CT was also performed at 3 children and sialography was used on 1 child. Follow-ups on ultrasonography were performed on 5 children from 3 months to 2 years since the initial sonographic examination. RESULTS: Ultrasonography demonstrated abnormalities in the 13 parotid glands: enlarged diffusion (n=9); decrease in diffusion of parenchymal echoes with multiple small round hypoechoic lesions measuring about 1-4mm in diameter (n=13); increased color Doppler vascular signals (n=10). There were symptomatic glands (n=12) and an asymptomatic gland (n=1). CT revealed multiple tiny low density lesions scattered about in the inhomogenously enhanced parotid glands. Sialography showed minimal sialectasis of the peripheral ducts. Follow-ups on sonography demonstrated near complete subsidence of enlargement, increased Doppler vascular signals, and persistence of multiple small hypoechoic lesions of the parotid glands in 6 cases who were clinically free of symptoms. In 1 case, multiple small hypoechoic lesions were newly developed in the previously healthy parotid gland. CONCLUSION: The sonographic features of recurrent parotitis in childhood were decreased diffusion of the parenchymal echoes with multiple small round hypoechoic areas and increased Doppler flow signals. We consider the sonographic evaluation of the parotid gland with the color Doppler study to be useful in diagnosing and monitoring the progress of recurrent parotitis in childhood.
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