Department of Otolaryngology, Medical University of Gdansk, 7 Dębinki St., 80-952 Gdansk, Poland.
Second Department of Radiology, Medical University of Gdansk, 7 Dębinki St., 80-952 Gdansk, Poland.
Oral Oncol. 2020 Dec;111:104932. doi: 10.1016/j.oraloncology.2020.104932. Epub 2020 Jul 30.
To verify if differential diagnostic algorithms based on selected parameters of dynamic and diffusion-weighted MRI, clinical and demographic variables are accurate enough to differentiate between parotid malignancies, pleomorphic adenomas and Warthin tumors.
The study included 84 patients, among them 19 (23%) with postoperative diagnosis of a parotid malignancy, 37 (44%) with Warthin tumors and 28 (33%) with pleomorphic adenomas. Accuracy of dynamic and diffusion-weighted MRI parameters (T, T, WR and ADC), clinical parameters of the tumor (location in the superficial or deep parotid lobe, single vs. multiple lesion, concomitant lymphadenopathy) and demographic characteristics of the patient (age, sex) was determined on ROC analysis.
Compared to Warthin tumors, parotid malignancies showed higher T, T and ADC, lower WR, were more often located in the deep lobe of the parotid and presented as single lesions with concomitant lymphadenopathy. Consideration of all these variables provided 100% sensitivity and 89.2% specificity of the differential diagnostic algorithm. Compared to pleomorphic adenomas, parotid malignancies presented with lower ADC and T, higher T, were more often located in the deep lobe of the parotid, associated with concomitant lymphadenopathy, diagnosed in men and individuals older than 66 years. Consideration of all these variables provided 100% sensitivity and 96.4% specificity of the differential diagnostic algorithm.
Combined analysis of clinical data and results of dynamic and diffusion-weighted MRI may provide nearly ideal accuracy in differential diagnostics of parotid malignancies and the two most common histological types of benign tumors.
验证基于动态和弥散加权 MRI 选择参数、临床和人口统计学变量的鉴别诊断算法是否足够准确，以区分腮腺恶性肿瘤、多形性腺瘤和沃辛瘤。
本研究纳入 84 例患者，其中 19 例（23%）术后诊断为腮腺恶性肿瘤，37 例（44%）为沃辛瘤，28 例（33%）为多形性腺瘤。通过 ROC 分析确定动态和弥散加权 MRI 参数（T1、T2、WR 和 ADC）、肿瘤临床参数（位于腮腺浅叶或深叶、单发或多发病变、是否伴有淋巴结病）和患者人口统计学特征（年龄、性别）的准确性。
与沃辛瘤相比，腮腺恶性肿瘤 T1、T2 和 ADC 值更高，WR 值更低，更多位于腮腺深叶，表现为单发病变伴淋巴结病。考虑所有这些变量的鉴别诊断算法的敏感性为 100%，特异性为 89.2%。与多形性腺瘤相比，腮腺恶性肿瘤的 ADC 和 T1 值更低，T2 值更高，更多位于腮腺深叶，伴淋巴结病，诊断为男性和年龄大于 66 岁的个体。考虑所有这些变量的鉴别诊断算法的敏感性为 100%，特异性为 96.4%。
临床数据和动态及弥散加权 MRI 结果的综合分析可为腮腺恶性肿瘤和两种最常见的良性肿瘤的鉴别诊断提供几乎理想的准确性。
