Routine and Advanced Ultrasound of Major Salivary Glands.

Ultrasound is the preferred initial imaging modality in Europe and Asia for assessing the major salivary glands. In experienced hands, it is sensitive for a range of salivary pathologies, often diagnostic, and also a safe, cost-effective gatekeeper for further investigations as well as image-guided diagnostic biopsies and aspirations. This article reviews the scanning technique and normal sonographic anatomy of major salivary glands and overviews typical sonographic appearances of salivary pathologies, including infective and inflammatory conditions, sialolithiasis, and neoplasms. Limitations of ultrasound and the current evidence for advanced techniques, including contrast-enhanced ultrasound and ultrasound elastography, are also discussed.