Salivary gland diseases may present clinically as a facial / neck lump, diffuse swelling or pain. Common major salivary gland abnormalities include calculus-related disease, acute or chronic inflammatory conditions, salivary gland neoplasms and vascular lesions. High-resolution ultrasound (US) is an ideal initial imaging investigation. In most circumstances, salivary gland abnormalities are adequately assessed by ultrasound supplemented by fine needle aspiration cytology (FNAC). In addition, US helps to select patients who may require further imaging studies such as contrast sialography, computed tomography (CT) and magnetic resonance imaging (MRI).

Ultrasound features such ill-defined margin, infiltration of adjacent structures, presence of intratumoral disorganized vascularity and abnormal regional lymphadenopathy help to identify salivary gland malignancies. Ultrasound also provides image guidance for FNAC or biopsy of suspected salivary gland malignancy. US is unable to evaluate the deep lobe of the parotid gland and in such cases MRI is particularly useful in assessing the deep lobes and evaluating the extent of large parotid lesions.

The aim of this presentation is to discuss the imaging features of salivary gland malignancy and other commonly encountered salivary gland lesions including calculus-related disease, acute / chronic inflammatory conditions, and benign salivary gland neoplasms.