[Value of manifestations of magnetic resonance imaging (MRI) in diagnosis of parotid tumors and their pathological bases].

BACKGROUND & OBJECTIVE: The pathologic types of parotid tumor are very complicated and the advantage of magnetic resonance imaging (MRI) in diagnosis of these tumors is very obvious; however, there is not still accordance at several areas of MRI diagnosis of them. A large amount of cases are needed for analyzing these MRI features and their pathological fundament. This study was conducted to summarize the MRI manifestations of common benign and malignant tumors and to explore the value of the morphological features of MRI in histological diagnosis of parotid tumor.

METHODS

The MRI manifestations for 132 cases(140 lesions) of parotid tumor/lesion were collected, including 89 benign tumors/lesions and 43 malignant tumors. Of them, 112 cases were proved by surgery, 17 cases by biopsy, and 3 cases by clinic observation. MRI features were completely compared with pathological results of surgical samples slice by slice in 58 cases. T(1)WI and T(2)WI sequence were used in MRI unenhancement scan; 108 cases (115 lesions) were examined with both unenhancement and enhancement. Chi-square test was used for statistic analysis.

RESULTS

(1) The MRI features of common parotid benign tumors were as following: 40 cases of Warthin's tumors enhanced slightly and more than half of them (25 cases) appeared low or equal signal intensity in T(2)WI; 22 cases of pleomorphic adenoma appeared high and unhomogeneous signal intensity in T(2)WI; 5 cases of hemangioma were characterized by their vascular structures which were enlarged than normal; 3 cases of lymphangioma not only appeared specially irregular shape but also surrounded adjacent structures of parotid gland (3 cases). The features of 4 cases of parotid lipoma were same as those in other position of the body.(2) The MRI features of common parotid malignant tumors were as following: 8 cases of malignant pleomorphic adenoma appeared high and unhomogeneous signals in T(2)WI together with irregular shape and ill-defined margin; 7 cases of adenoid cystic carcinoma characterized by invasion of very large range surrounding parotid gland. In 8 cases of malignant mucoepidermoid carcinoma, 3 cases showed low-grade malignant mucoepidermoid carcinomas, which had well-defined margin and were difficult to distinguish from benign tumor. However, 5 cases of high-grade malignant mucoepidermoid carcinoma showed ill-defined margin, their features were tend to undergo necrosis and invade lymph node; 9 cases of lymphomas were all secondary lesions and there were two characters in their imaging, one was the wide involved range, the other was they consisted of several nodes. The shapes of 3 cases acinic cell carcinoma could be either regular or irregular, the cystic areas could be found in them with high signal intensity both on T(1)WI and T(2)WI.

CONCLUSION

There are certain characters for each of common benign and malignant parotid tumors in MRI and these may be helpful for histological diagnosis in most of them.