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Abstract Objective: To explore the value of multimodal magnetic resonance imaging (MRI) technology in distinguishing parotid Warthin tumor and pleomorphic adenoma. Methods: The data of patients with pathologically confirmed Warthin tumors of the parotid gland (62 cases, 66 lesions) and pleomorphic adenomas (47 cases, 49 lesions) admitted to the hospital from October 2017 to May 2021 retrospectively analyzed, all patients underwent routine MRI, diffusion weighted imaging (DWI), and dynamic contrast enhancement (DCE) examinations before surgery.Clinical characteristics, apparent diffusion coefficient (ADC) values and DCEMRI parameter values of patients with Warthin tumor and pleomorphic adenoma of the parotid gland were compared. In addition, the receiver operating characteristic (ROC) curve was used to analyze the differential value of ADC value and DCEMRI parameter value in parotid Warthin tumor and pleomorphic adenoma. Results: There were no significant difference in maximum crosssectional area of the lesion, lesion location, lesion shape, and lesion boundary between patients with Warthin tumor of the parotid gland and pleomorphic adenoma (P>0.05), the difference in the ratio of male to female in the two groups was statistically significant (P<0.001), patients with Warthin tumor of the parotid gland were less cystic than those with pleomorphic adenoma (P<0.001). The ADC value of patients with Warthin tumor of the parotid gland was lower than that of patients with pleomorphic adenoma (P<0.001). There were no statistically significant difference in the rate constant (Kep) and initial area under the contrast agent concentration curve (iAUC) between patients with Warthin tumor of the parotid gland and pleomorphic adenoma (P>0.05). The volume transfer constant (Ktrans) value of patients with Warthin tumor of the parotid gland was higher than that of patients with pleomorphic adenoma (P<0.001), the extravascular extracellular space volume ratio (Ve) of patients with Warthin tumor of the parotid gland was lower than that of patients with pleomorphic adenoma (P<0.001). ROC analysis shows that the best cutoff points for ADC, Ktrans, and Ve were 1.00×10-3 mm2/s, 0.19 min-1, 0.42, the sensitivity were 81.82%, 83.33%, 84.85%, the specificity were 73.47%, 77.55%, 69.39%, and the area under the curve (AUC) were 0.814, 0.741, 0.760, respectively. The specificity and AUC of the combination of the three were 95.92% and 0.866, respectively. Conclusion: Multimodal MRI technology has high clinical application value for the differential diagnosis of parotid Warthin tumor from pleomorphic adenoma.
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Received: 04 November 2021
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