Ultrasound is a sensitive tool for assessing focal salivary gland lesions and is the initial imaging modality of choice for investigating such conditions. Whilst certain lesions have very characteristic ultrasound appearances, many hyperechoic lesions have non-specific imaging features resulting in diagnostic uncertainty based on imaging alone. Here we review the appearances of these lesions on ultrasound and highlight the importance of proceeding to ultrasound-guided fine-needle aspiration for cytology or core biopsy to reach a definitive diagnosis.
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