Parotid masses: MR imaging.

Over a 2-year period 20 patients who presented with masses in the parotid gland were evaluated with magnetic resonance (MR) imaging. T1-weighted images were obtained on a high-resolution, thin-section MR imaging system. When "cystic-appearing" lesions were found, T2-weighted images were obtained in order to better characterize the tumor. As in other areas of the body, MR images of parotid tumors are not usually histologically specific. MR findings may be distinctive in rare cases and define the internal architecture of complex parotid masses. Although poor tumor margination was a clue to malignancy, this was not a consistent finding. The real advantage of MR imaging in evaluating parotid masses was its ability to accurately reveal the extraparotid or intraparotid location of a tumor and demonstrate the relationship of the tumor to the facial nerve. Small and medium-sized mass lesions could be seen as superficial or deep to the facial nerve. Larger masses producing some distortion of the normal course of the nerve made identification of the nerve more difficult, if not impossible. In malignant tumors with gross invasion of the facial canal, MR images can show the extent of nerve involvement.