Gaudino Chiara, Cassoni Andrea, Pisciotti Martina Lucia, Pucci Resi, Veneroso Chiara, Di Gioia Cira Rosaria Tiziana, De Felice Francesca, Pantano Patrizia, Valentini Valentino
Department of Neuroradiology, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy.
Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy.
Cancers (Basel). 2024 Dec 29;17(1):71. doi: 10.3390/cancers17010071.
Imaging of parotid tumors is crucial for surgery planning, but it cannot distinguish malignant from benign lesions with absolute reliability. The aim of the study was to establish a diagnostic MRI algorithm to differentiate parotid tumors. A retrospective study was conducted including all patients with parotid tumors, who underwent 3T-MRI and surgery. Morphological characteristics and normalized T2 and late postcontrast T1 signal intensities (SI) were assessed. "Ghosting sign" on late postcontrast T1 sequence was defined as indistinguishability of the tumor except for a thin peripheral enhancement. Patients were divided according to histology and imaging data were compared. A diagnostic MRI algorithm was established. Thirty-six patients were included. The combination of normalized late T1 postcontrast SI, normalized T2 SI and "ghosting sign" allowed for the distinguishing of malignant from benign parotid tumors with high sensitivity (100%), specificity (93%), positive predictive value (80%), negative predictive value, (100%) and accuracy (94%). Moreover, pleomorphic adenomas often showed a homogeneous T2 signal and a complete capsule ( < 0.01), Warthin tumors protein-rich cysts and calcifications ( < 0.005 and < 0.05), and malignant tumors an inhomogeneous contrast enhancement ( < 0.01). High field MRI represents a promising tool in parotid tumors, allowing for an accurate differentiation of malignant and benign lesions.
腮腺肿瘤的影像学检查对于手术规划至关重要，但它无法绝对可靠地区分恶性和良性病变。本研究的目的是建立一种诊断性MRI算法以鉴别腮腺肿瘤。进行了一项回顾性研究，纳入了所有接受3T-MRI检查和手术的腮腺肿瘤患者。评估了形态学特征以及T2加权像和增强后延迟T1加权像的标准化信号强度（SI）。增强后延迟T1序列上的“幻影征”定义为除薄的周边强化外肿瘤难以分辨。根据组织学对患者进行分组，并比较影像学数据。建立了一种诊断性MRI算法。共纳入36例患者。标准化增强后延迟T1加权像SI、标准化T2加权像SI和“幻影征”的联合应用能够以高灵敏度（100%）、特异性（93%）、阳性预测值（80%）、阴性预测值（100%）和准确性（94%）区分腮腺恶性肿瘤和良性肿瘤。此外，多形性腺瘤常表现为均匀的T2信号和完整的包膜（P<0.01），沃辛瘤表现为富含蛋白的囊肿和钙化（P<0.005和P<0.05），而恶性肿瘤表现为不均匀的强化（P<0.01）。高场强MRI是鉴别腮腺肿瘤的一种有前景的工具，能够准确区分恶性和良性病变。
