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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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[1]Horisk N,Stephenson E,Sayers C,et al. Incidental finding of synchronous pleomorphic salivary adenoma and Warthin′s tumour within a parotid gland [J]. BMJ Case Rep, 2019,12(4): 675-683.
[2]Coudert H, Mirafzal S, Dissard A, et al. Multiparametric magnetic resonance imaging of parotid tumors: A systematic review [J]. Diagn Interv Imaging, 2021, 102(3): 121-130.
[3]张爱华,张志军. 腮腺多形性腺瘤与Warthin瘤的CT表现及鉴别诊断[J]. 北京医学, 2018, 40(12): 1185-1186.
[4]周宇堃,甄俊平,靳波,等. 基于T1WI及IDEALT2WI影像组学模型鉴别腮腺多形性腺瘤和腺淋巴瘤[J]. 中国医学影像技术, 2020, 36(5): 675-679.
[5]Karaman CZ, Tanyeri A, zgür R, et al. Parotid gland tumors: comparison of conventional and diffusionweighted MRI findings with histopathological results [J]. Dentomaxillofac Radiol, 2021, 50(4): 391-396.
[6]王巍,王超,宋金丹. 腮腺多形性腺瘤与Warthin瘤的CT和MRI的影像学特征[J]. 临床和实验医学杂志, 2020, 19(6): 660-663.
[7]顾仲毅,耿杨杨,冯浩,等.影像学方法在子宫颈癌分期中的运用和发展[J].江苏大学学报(医学版), 2017, 27(2): 172-175.
[8]单世航,柴华,彭明群,等. 弥散加权成像及动态增强磁共振成像在腮腺多形性腺瘤与Warthin′s瘤鉴别诊断中的价值[J]. 中国医学装备, 2019,16(10): 51-54.
[9]满育平,马隆佰,林华,等. 多模态MRI对腮腺多形性腺瘤和腺淋巴瘤的诊断价值[J]. 放射学实践, 2018, 33(12): 19-23.
[10]于冬洋,单奔,柳勇,等. 3.0T磁共振DWI及动态增强扫描在腮腺常见肿瘤中的诊断价值[J]. 中华全科医师杂志, 2018, 17(4): 303-306.
[11]张杨,刘斌. 腮腺多形性腺瘤MRI特征评分对定性诊断的有效性评估[J]. 临床放射学杂志, 2018, 37(2): 204-208.
[12]Jiang JS, Zhu LN, Chen W, et al. Added value of susceptibilityweighted imaging to diffusionweighted imaging in the characterization of parotid gland tumors [J]. Eur Arch Otorhinolaryngol, 2020, 277(10): 2839-2846.
[13]王海滨,郇通,韩志江,等. 腮腺多形性腺瘤常规MR征象与病理相关性分析[J]. 中国临床医学影像杂志, 2020, 31(11): 29-33.
[14]冯浩,邝菲,杨林根. ADC值在腮腺多形性腺瘤和腺淋巴瘤鉴别诊断中的应用价值探讨[J]. 医疗卫生装备, 2018, 39(3): 65-68.
[15]Chen P, Dong B, Zhang C, et al. The histogram analysis of apparent diffusion coefficient in differential diagnosis of parotid tumor [J]. Dentomaxillofac Radiol, 2020, 49(5): 420-426.
[16]郑少燕,曾向廷,吴先衡, 等. 3.0T MR动态增强及DWI对腮腺肿瘤鉴别诊断的价值[J]. 临床放射学杂志, 2018, 37(1): 38-43.
[17]程景风,郑宁,邵硕, 等. 3.0T多参数MRI在鉴别腮腺基底细胞腺瘤和多形性腺瘤中的诊断价值[J]. 实用放射学杂志, 2020, 36(4): 550-553.
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[1] |
. [J]. Journal of Jiangsu University(Medicine Edition), 2018, 28(04): 367-368. |
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