Yabuuchi Hidetake, Fukuya Tatsuro, Tajima Tsuyoshi, Hachitanda Yoichi, Tomita Kichinobu, Koga Mitsuru
Department of Radiology, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan.
Radiology. 2003 Feb;226(2):345-54. doi: 10.1148/radiol.2262011486.
To evaluate the diagnostic value of gadolinium-enhanced dynamic magnetic resonance (MR) imaging of salivary gland tumors and correlate the MR imaging and histopathologic findings.
Thirty-three salivary gland tumors in 29 patients were examined preoperatively at gadolinium-enhanced dynamic MR imaging. There were 22 benign and 11 malignant tumors. Dynamic contrast material-enhanced MR images were obtained for 5 minutes. Time of peak enhancement (T(peak)) and washout ratio (WR) were determined from time-signal intensity curves (TICs). Microvessel count and cellularity-stromal grade were evaluated histopathologically. The strengths of correlations between T(peak) and microvessel count and between WR and cellularity-stromal grade were statistically analyzed. Statistical analysis was also performed to determine whether any differences among the various histopathologic tumor types existed [corrected]. In a validation study, 13 salivary gland tumors in 13 patients were examined consecutively.
At a T(peak) of 120 seconds, malignant tumors could be differentiated from pleomorphic adenomas but not from Warthin tumors. A WR of 30%, however, enabled differentiation between malignant and Warthin tumors. Classification of TICs on the basis of a T(peak) of 120 seconds and a WR of 30% had high sensitivity (91%) and specificity (91%) in the differentiation of benign and malignant tumors. Correlations between T(peak) and microvessel count (P <.0001, rho = -0.800) and between WR and cellularity-stromal grade (P =.0105, rho = 0.572) were significant. The validation study also yielded high sensitivity (100%) and specificity (80%) in the differentiation between benign and malignant tumors.
Gadolinium-enhanced dynamic MR imaging is useful for differentiating benign from malignant salivary gland tumors.
评估钆增强动态磁共振（MR）成像对涎腺肿瘤的诊断价值，并将MR成像结果与组织病理学结果进行关联。
对29例患者的33个涎腺肿瘤进行术前钆增强动态MR成像检查。其中良性肿瘤22个，恶性肿瘤11个。动态对比剂增强MR图像采集5分钟。从时间-信号强度曲线（TICs）确定峰值增强时间（T(peak)）和洗脱率（WR）。组织病理学评估微血管计数和细胞-基质分级。对T(peak)与微血管计数之间以及WR与细胞-基质分级之间的相关性强度进行统计学分析。还进行了统计学分析以确定不同组织病理学肿瘤类型之间是否存在差异[校正后]。在一项验证研究中，对13例患者的13个涎腺肿瘤进行了连续检查。
在T(peak)为120秒时，恶性肿瘤可与多形性腺瘤相鉴别，但不能与沃辛瘤相鉴别。然而，洗脱率为30%时可区分恶性肿瘤与沃辛瘤。基于T(peak)为120秒和洗脱率为30%对TICs进行分类，在鉴别良性和恶性肿瘤方面具有高敏感性（91%）和特异性（91%）。T(peak)与微血管计数之间（P <.0001，rho = -0.800）以及WR与细胞-基质分级之间（P =.0105，rho = 0.572）的相关性显著。验证研究在鉴别良性和恶性肿瘤方面也产生了高敏感性（100%）和特异性（80%）。
钆增强动态MR成像有助于鉴别涎腺肿瘤的良恶性。
