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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleHead and Neck Imaging

Diffusion-Weighted Echo-Planar MR Imaging of Primary Parotid Gland Tumors: Is a Prediction of Different Histologic Subtypes Possible?

C.R. Habermann, C. Arndt, J. Graessner, L. Diestel, K.U. Petersen, F. Reitmeier, J.O. Ussmueller, G. Adam and M. Jaehne
American Journal of Neuroradiology March 2009, 30 (3) 591-596; DOI: https://doi.org/10.3174/ajnr.A1412
C.R. Habermann
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C. Arndt
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J. Graessner
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L. Diestel
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K.U. Petersen
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F. Reitmeier
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J.O. Ussmueller
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G. Adam
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M. Jaehne
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    Fig 1.

    The boxplots demonstrate the mean value, 95% confidence interval (CI), and minimum and maximum values for each tumor entity with a number of patients >1. The central line of each boxplot indicates the mean value, whereas the range of the box displays the 95% CI. The whiskers represent the minimal and maximal values (unit of the vertical axis: × 10−3 mm2/s).

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    Fig 2.

    A, Transverse T1-weighted spin-echo MR image (TR, 500 ms; TE, 14 ms) from a 69-year-old male patient with a histologically proved pleomorphic adenoma within the right parotid gland (arrow). The mass shows muscle-isointense signal intensity. B, The corresponding T2-weighted 3D true FISP (TR, 700 ms; TE, 2.29 ms) image has a bright lesion within the right parotid gland (arrow). C, The corresponding ADC map shows an easily detectable bright signal intensity of the lesion (mean ADC value: 2.14 × 10−3 mm2/s; arrow).

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    Fig 3.

    A, Transverse T1-weighted spin-echo MR image (TR, 500 ms; TE, 14 ms) from a 49-year-old female patient with a histologically proved Warthin tumor in the left parotid gland (arrow). B, The T2-weighted image (3D true FISP; TR, 700 ms; TE, 2.29 ms) also shows a bright signal intensity of the lesion (arrow) with a lesser extent but appearance similar to that of the pleomorphic adenoma in Fig 2B. C, On the basis of ADC maps, the difference between the pleomorphic adenoma in Fig 2C and the Warthin tumor shown (arrow) becomes obvious (mean ADC value: 0.85 × 10−3 mm2/s).

Tables

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    Table 1:

    Histopathologic diagnoses of examined primary salivary gland tumors

    DiagnosisNo. of Lesions (n = 136)
    Pleomorphic adenoma43
    Warthin tumor32
    Myoepithelial adenoma6
    Lipoma3
    Basal cell adenoma1
    Cystadenoma1
    Inverted ductal papilloma1
    Mucoepidermoid carcinoma16
    Salivary duct carcinoma11
    Acinic cell carcinoma10
    Basal cell adenocarcinoma9
    Adenoid cystic carcinoma1
    Epithelial-myoepithelial carcinoma1
    Carcinoma ex pleomorphic adenoma1
    • View popup
    Table 2:

    Mean ADC values of all histologically proved entities of parotid gland tumors (n = 136)*

    DiagnosisMean ADC values ± SD (95% CI) (× 10−3 mm2/s)
    Pleomorphic adenoma (n = 43)2.09 ± 0.16 (2.03–2.14)
    Warthin tumor (n = 32)0.89 ± 0.16 (0.82–0.96)
    Myoepithelial adenoma (n = 6)1.86 ± 0.18 (1.83–1.91)
    Lipoma (n = 3)0.62 ± 0.21 (0.54–0.76)
    Basal cell adenoma (n = 1)1.23
    Cystadenoma (n = 1)2.29
    Inverted ductal papilloma (n = 1)1.99
    Mucoepidermoid carcinoma (n = 16)1.05 ± 0.03 (0.97–1.14)
    Salivary duct carcinoma (n = 11)1.10 ± 0.09 (0.89–1.31)
    Acinic cell carcinoma (n = 10)0.79 ± 0.33 (0.68–0.88)
    Basal cell adenocarcinoma (n = 9)0.96 ± 0.29 (0.71–1.12)
    Adenoid cystic carcinoma (n = 1)0.87
    Epithelial-myoepithelial carcinoma (n = 1)0.92
    Carcinoma ex pleomorphic adenoma (n = 1)1.14
    • Note:—CI indicates confidence interval; ADC, apparent diffusion coefficient.

    • * In case of a single tumor, SD and 95% CI were not calculated.

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    Table 3:

    Level of significance of calculated mean ADC values comparing all observed entities (n > 1)

    Warthin TumorsMyoepithelial AdenomasLipomasMucoepidermoid CarcinomasSalivary Duct CarcinomasAcinic Cell CarcinomasBasal Cell Adenocarcinomas
    Pleomorphic adenomas<.001.054*<.001<.001<.001<.001<.001
    Warthin tumors<.001.013.094*.037.396*.604*
    Myoepithelial adenomas.009.133*.014.032.082*
    Lipomas.024.022.48*.222*
    Mucoepidermoid carcinomas.430*.246*.569*
    Salivary duct carcinoma.195*.446*
    Acinic cell carcinomas.616*
    • * Non-statistically significant differences.

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American Journal of Neuroradiology: 30 (3)
American Journal of Neuroradiology
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March 2009
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Diffusion-Weighted Echo-Planar MR Imaging of Primary Parotid Gland Tumors: Is a Prediction of Different Histologic Subtypes Possible?
C.R. Habermann, C. Arndt, J. Graessner, L. Diestel, K.U. Petersen, F. Reitmeier, J.O. Ussmueller, G. Adam, M. Jaehne
American Journal of Neuroradiology Mar 2009, 30 (3) 591-596; DOI: 10.3174/ajnr.A1412
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C.R. Habermann, C. Arndt, J. Graessner, L. Diestel, K.U. Petersen, F. Reitmeier, J.O. Ussmueller, G. Adam, M. Jaehne
Diffusion-Weighted Echo-Planar MR Imaging of Primary Parotid Gland Tumors: Is a Prediction of Different Histologic Subtypes Possible?
American Journal of Neuroradiology Mar 2009, 30 (3) 591-596; DOI: 10.3174/ajnr.A1412

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