Röntgeninstitut Marktgasse AG, RIMED AG, Marktgasse 6/8, 3011, Bern, Switzerland.
Department of Otorhinolaryngology - Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
BMC Med Imaging. 2022 Nov 7;22(1):191. doi: 10.1186/s12880-022-00924-0.
Imaging of parotid gland tumors is challenging due to the wide variety of differential diagnoses. Malignant parotid tumors can have very similar features to benign ones, such as slow growth and displacement instead of infiltration of neighboring structures. Malignant and benign tumors may therefore not be clinically distinguishable. Correct characterization of parotid tumors (i.e., benign or malignant) determines preoperative treatment planning and is important in optimizing the individualized surgical plan. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluation of suspected parotid gland lesions and differentiation between benign and malignant lesions. Certain conventional MRI features can suggest whether a mass is more likely to be a benign or low-grade malignancy or a high-grade malignancy and adding diffusion-weighted imaging or advanced MRI techniques like perfusion can aid in this distinction. Morphological features seen on MRI, such as low signal on T2-w, infiltrative changes or ill-defined margins, change over time and diffusion restriction can point to the malignant nature of the lesion. MRI is useful for detection and localization of the lesion(s), and associated findings like perineural spread of tumor, lymph node involvement and infiltrative changes of the surrounding tissues. In this pictorial essay, we present selected images of a variety of benign and malignant parotid tumors and emphasize the MRI features that may be useful in their characterization.
由于鉴别诊断广泛,因此对腮腺肿瘤的影像学检查具有挑战性。恶性腮腺肿瘤的特征可能与良性肿瘤非常相似,例如生长缓慢和移位而不是邻近结构浸润。因此,恶性和良性肿瘤可能在临床上无法区分。正确描述腮腺肿瘤(即良性或恶性)可确定术前治疗计划,并有助于优化个体化手术计划。磁共振成像(MRI)是评估可疑腮腺病变和区分良性和恶性病变的首选影像学方法。某些常规 MRI 特征可提示肿块更可能是良性或低度恶性肿瘤还是高度恶性肿瘤,并且添加扩散加权成像或灌注等高级 MRI 技术可以帮助进行这种区分。MRI 上观察到的形态学特征,例如 T2 加权低信号、浸润性改变或边界不清,随时间变化而变化,扩散受限可提示病变的恶性性质。MRI 可用于检测和定位病变,以及相关发现,如肿瘤的神经周围扩散、淋巴结受累和周围组织的浸润性改变。在本影像学论文中,我们展示了各种良性和恶性腮腺肿瘤的精选图像,并强调了可能有助于其特征描述的 MRI 特征。