PURPOSE: To assess the usefulness of MR findings in establishing a specific diagnosis of parotid pleomorphic adenoma. METHODS: T1-weighted and T2-weighted MR images with and without contrast enhancement were obtained in 82 patients with parotid tumors. Imaging findings in the 38 patients in whom surgery subsequently revealed pleomorphic adenomas were compared with findings in the 44 patients who had other types of tumor. Specifically, the homogeneity, signal intensity, contrast enhancement, capsule thickness, lobulation, adenopathy, and infiltration of adjacent fat were compared among the different types of tumor. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated. RESULTS: A low-signal capsule on T2-weighted images and a lobulated contour characterized most pleomorphic adenomas. The sensitivity of the first finding for pleomorphic adenoma was 82%; specificity, 85%; positive predictive value, 82%; and negative predictive value, 84%. For the second finding, the sensitivity was 53%; specificity, 84%; positive predictive value, 74%; and negative predictive value, 67%. CONCLUSION: None of the signs evaluated had perfect sensitivity and specificity. The MR findings of a complete capsule, lobulated contour, or high T2 signal intensity have a high predictive value for the diagnosis of pleomorphic adenoma.
PURPOSE: To assess the usefulness of MR findings in establishing a specific diagnosis of parotid pleomorphic adenoma. METHODS: T1-weighted and T2-weighted MR images with and without contrast enhancement were obtained in 82 patients with parotid tumors. Imaging findings in the 38 patients in whom surgery subsequently revealed pleomorphic adenomas were compared with findings in the 44 patients who had other types of tumor. Specifically, the homogeneity, signal intensity, contrast enhancement, capsule thickness, lobulation, adenopathy, and infiltration of adjacent fat were compared among the different types of tumor. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated. RESULTS: A low-signal capsule on T2-weighted images and a lobulated contour characterized most pleomorphic adenomas. The sensitivity of the first finding for pleomorphic adenoma was 82%; specificity, 85%; positive predictive value, 82%; and negative predictive value, 84%. For the second finding, the sensitivity was 53%; specificity, 84%; positive predictive value, 74%; and negative predictive value, 67%. CONCLUSION: None of the signs evaluated had perfect sensitivity and specificity. The MR findings of a complete capsule, lobulated contour, or high T2 signal intensity have a high predictive value for the diagnosis of pleomorphic adenoma.
Authors: C M Tomblinson; G P Fletcher; T K Lidner; C P Wood; S M Weindling; J M Hoxworth Journal: AJNR Am J Neuroradiol Date: 2018-11-08 Impact factor: 3.825