salivary gland imagingRazek, AA. Neuroimaging Clinics of North America: Imaging of Salivary Glands. Elselvier; 2018; pp 137–318; $386.90

The latest edition of Neuroimaging Clinics of North America: Imaging of Salivary Glands (May 2018), edited by Ahmed Razek, MD, discusses various aspects of salivary gland imaging. In 12 separate chapters with authorship from 22 contributors, this 180- page volume deals with virtually every subject in salivary gland imaging, ranging from normal anatomy and imaging techniques (1st chapter) through many of what one could consider advanced (non-routine) techniques. Included is a 20-page chapter on ultrasound of the major salivary glands (in addition to one line video context).

The initial chapter is a vital starting point since all of the pertinent anatomy, along with anatomic variants, basic physiology, and all techniques (CT, MR, DWI, sialography, PET) are covered. This is a particularly well written chapter, and in a 20-page span, sets the stage for what follows. Two chapters succeed, describing and illustrating salivary gland neoplasms, both benign and malignant. Reviewing the images themselves with the associated legends, allow one to grasp a wide range of tumor appearances on CT and MR.

A chapter on Sjögren Syndrome and IgG4 inflammatory disease stresses the frequency with which these abnormalities are seen; pointers in describing these are important parts of this chapter. One of the trickiest issue to deal with is how to analyze images obtained following the treatment of salivary gland lesions; in this brief chapter descriptions of treatment options are summarized, including the normal post-op appearance and findings in local/regional recurrence, along with PNS (perineural spread).

A separate chapter with multiple (and often hard to obtain) images deals with pediatric salivary glands—and as one might expect—a number of congenital/genetic abnormalities are included.

Fortunately, ample material is included in the chapter on the submandibular and sublingual salivary glands; excellent drawings (in color) help explain the relatively complex anatomy in both of these regions. As imaging seeks to differentiate one abnormality/lesion from another, we naturally become involved with more advanced techniques—particularly the utilization of DWI. Manipulation of the imaging factors allow an attempt to characterize lesions more fully, depending on diffusion characteristics.

More unusual lesions and inflammatory disorders—both infectious and non-infectious—are described in a well-illustrated chapter, allowing one to read about rarely encountered manifestations, in addition to the more commonly seen infectious diseases involving these glands and their surrounding soft lesions. As radiologists are well aware, there are multiple sites of minor salivary glands, so an emphasis on this, and the frequent occurrence of tumors in these glands is described.

This particular volume of Neuroimaging Clinics of North America ends with a chapter describing current state-of-the-art imaging of salivary gland tumors. However, there should have been closer attention paid during the editing of this volume, as there are places where redundancies occur—and where incorrect words are used—but these are minor criticisms.

Overall, this is highly useful volume, because it deals with the issues (simple and complex) which are encountered on a nearly routine basis, and particularly so in any practice where there is a heavy load of head and neck surgery. Neuroimaging Clinics of North America: Imaging of Salivary Glands is highly recommend for purchase by all radiologists.

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