title: Two-phase helical computed tomography study of salivary gland warthin tumors: a radiologic findings and surgical applications.
abstract: OBJECTIVE
  The goal of this study was to define the radiologic characteristics of two-phase computed tomography (CT) of salivary gland Warthin tumors and to compare them to pleomorphic adenomas. We also aimed to provide a foundation for selecting a surgical method on the basis of radiologic findings.
  
  
  METHODS
  We prospectively enrolled 116 patients with parotid gland tumors, who underwent two-phase CT preoperatively. Early and delayed phase scans were obtained, with scanning delays of 30 and 120 seconds, respectively. The attenuation changes and enhancement patterns were analyzed. In cases when the attenuation changes were decreased, we presumed Warthin tumor preoperatively and performed extracapsular dissection. When the attenuation changes were increased, superficial parotidectomy was performed on the parotid gland tumors. We analyzed the operation times, incision sizes, complications, and recurrence rates.
  
  
  RESULTS
  Attenuation of Warthin tumors was decreased from early to delayed scans. The ratio of CT numbers in Warthin tumors was also significantly different from other tumors. Warthin tumors were diagnosed with a sensitivity of 96.1% and specificity of 97% using two-phase CT. The mean operation time was 38 minutes and the mean incision size was 36.2 mm for Warthin tumors. However, for the other parotid tumors, the average operation time was 122 minutes and the average incision size was 91.8 mm (P<0.05).
  
  
  CONCLUSIONS
  Salivary Warthin tumor has a distinct pattern of contrast enhancement on two-phase CT, which can guide treatment decisions. The preoperative diagnosis of Warthin tumor made extracapsular dissection possible instead of superficial parotidectomy.
authors.affiliation: Department of Otolaryngology, Gyeongsang National University Hospital, Jinju, Korea.
authors.forename: Yeon Hee
authors.initials: YH
authors.lastname: Joo
authors.affiliation: Department of Otolaryngology, Gyeongsang National University Hospital, Jinju, Korea.
authors.forename: Jin Pyeong
authors.initials: JP
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology, Gyeongsang National University Hospital, Jinju, Korea.
authors.forename: Jung Je
authors.initials: JJ
authors.lastname: Park
authors.affiliation: Department of Otolaryngology, Gyeongsang National University Hospital, Jinju, Korea. ; Institute of Health Sciences, Gyeongsang National University Hospital, Jinju, Korea.
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Woo
keywords: Adenolymphoma; Dissection; Parotid gland; Parotid neoplasms; Tomography