title: Differential diagnosis of parotid gland tumours: which magnetic resonance findings should be taken in account?
abstract: Our aim was to define typical magnetic resonance (MRI) findings in malignant and benign parotid tumours. This study is based on retrospective evaluation of pre-surgical MRI of 94 patients with parotid gland tumours. Histology results were available for all tumours. There were 69 cases of benign (73%) and 25 cases of malignant (27%) tumours, including 44 pleomorphic adenomas, 18 Warthin's tumours, 7 various benign tumours, 6 squamous cell carcinomas, 3 carcinoma ex pleomorphic adenomas, 2 mucoepidermoid carcinomas, 1 adenoid cystic carcinoma and 13 various malignant tumours. The following MRI parameters were evaluated: shape, site, size, margins, signal intensity (SI) on T1w and T2w images, contrast enhancement, signal of cystic content, presence or absence of a capsule, perineural spread, extraglandular growth pattern and cervical adenopathy. Statistical analysis was performed to identify the MRI findings most suggestive of malignancy, and to define the most typical MRI pattern of the most common histologies. Ill-defined margins (p < 0.001), adenopathies (p < 0.001) and infiltrative grown pattern (p < 0.001) were significantly predictive of malignancy. Typical findings of pleomorphic adenoma included hyperintensity on T2w images (p = 0.02), strong contrast enhancement (p < 0.001) and lobulated shape (p = 0.04). Typical findings of Warthin's tumour included hyperintense components on T1w images (p < 0.001), location in the parotid inferior process (p < 0.001) and mild or incomplete contrast enhancement (p = 0.01). SI on T1w and T2w images and contrast enhancement enables differential diagnosis between pleomorphic adenoma and Warthin's tumour.
authors.affiliation: Department of Radiological Sciences, Università Cattolica del Sacro Cuore, "A. Gemelli" Hospital, Roma, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Tartaglione
authors.affiliation: Department of Radiological Sciences, Università Cattolica del Sacro Cuore, "A. Gemelli" Hospital, Roma, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Botto
authors.affiliation: Department of Radiological Sciences, Università Cattolica del Sacro Cuore, "A. Gemelli" Hospital, Roma, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Sciandra
authors.affiliation: Department of Radiological Sciences, Università Cattolica del Sacro Cuore, "A. Gemelli" Hospital, Roma, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Gaudino
authors.affiliation: Department of Radiological Sciences, Università Cattolica del Sacro Cuore, "A. Gemelli" Hospital, Roma, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Danieli
authors.affiliation: Department of Head and Neck Surgery Otorhinolaryngology, Università Cattolica del Sacro Cuore, "A. Gemelli "Hospital, Roma, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Parrilla
authors.affiliation: Department of Head and Neck Surgery Otorhinolaryngology, Università Cattolica del Sacro Cuore, "A. Gemelli "Hospital, Roma, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Paludetti
authors.affiliation: Department of Radiological Sciences, Università Cattolica del Sacro Cuore, "A. Gemelli" Hospital, Roma, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Colosimo
mesh_terms: D000235:Adenolymphoma / Q000175:diagnosis; D008949:Adenoma, Pleomorphic / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D010307:Parotid Neoplasms / Q000175:diagnosis*; D012189:Retrospective Studies
keywords: Differential diagnosis; Histology; Magnetic Resonance Imaging; Neoplasms; Parotid gland
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