Salivary Gland MRI: Parotid Masses & MR Sialography
For a lump in the parotid, MRI answers the surgeon’s questions: what is it likely to be, how deep does it go, and is the facial nerve at risk.
Characterising masses
MRI’s soft-tissue contrast, with DWI and dynamic contrast, helps separate the common lesions:
- Pleomorphic adenoma: very bright on T2, well-defined; the commonest benign tumour.
- Warthin tumour: often bilateral/multiple, lower T2, in smokers.
- Malignancy: low T2 signal, ill-defined margins, low ADC, and infiltration raise concern.
Extent that changes surgery
MRI defines whether a tumour is superficial or deep-lobe (relative to the facial nerve plane/retromandibular vein), parapharyngeal extension, and perineural spread along the facial nerve, all critical to operative planning and to warning about facial-nerve risk.
Ducts & inflammation
MR sialography (heavily T2-weighted) images the ductal system non-invasively for strictures and stones in obstructive/inflammatory disease, and MRI assesses chronic sialadenitis and Sjögren-related change.
Sources
- Christe A et al. MR imaging of parotid tumors: typical lesion characteristics. AJNR Am J Neuroradiol 2011;32:1202–07.
Educational summary for clinicians; tissue diagnosis required. Not medical advice.