Dynamic contrast-enhanced MR in the diagnosis of lympho-associated benign and malignant lesions in the parotid gland

Ling Zhu; Chunye Zhang; Yi Hua; Jie Yang; Qiang Yu; Xiaofeng Tao; Jiawei Zheng

doi:10.1259/dmfr.20150343

Dynamic contrast-enhanced MR in the diagnosis of lympho-associated benign and malignant lesions in the parotid gland

Dentomaxillofac Radiol. 2016;45(4):20150343. doi: 10.1259/dmfr.20150343. Epub 2016 Feb 5.

Authors

Ling Zhu¹, Chunye Zhang², Yi Hua³, Jie Yang⁴, Qiang Yu¹, Xiaofeng Tao¹, Jiawei Zheng⁵

Affiliations

¹ 1 Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
² 2 Department of Oral pathology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
³ 3 Department of prevention and health care, Preventive and health care center of Wuzhong economic developing-area, Suzhou, China.
⁴ 4 Division of Oral & Maxillofacial Radiology, Temple University School of Dentistry, and Department of Diagnostic Imaging, Temple University School of Medicine, PA, USA.
⁵ 5 Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Abstract

Objective: The aim of this study was to determine if dynamic contrast-enhanced (DCE)-MRI can differentiate mucosa-associated lymphoid tissue (MALT) lymphoma from benign lymphoepithelial lesion (BLEL) in the parotid gland.

Methods: 25 patients with tumour-like BLEL and 20 patients with MALT lymphoma in the parotid gland confirmed by pathology were examined pre-operatively using routine MR series and DCE-MRI with a 1.5-T MR unit. The time to peak (TTP), time to start (TTS), SIstart, SImax and SIending were measured and the initial slope of increase (ISI) and relative washout ratio (RWO) were calculated separately from the time-intensity curve (TIC), and the types of TIC were analysed.

Results: There were significant differences in the TTP and ISI between the two lesions (p < 0.001). The sensitivity, specificity and accuracy of TTP were all more than 90%. TICs were divided into three types according to the threshold of TTP and ISI: tumour-like BLEL: gradual type (Type II) and late increase type (Type III); MALT lymphoma: rapid increase and gradual type (Type I).

Conclusions: DCE-MRI contributed greatly to the differential diagnosis between tumour-like BLEL and MALT lymphoma in the parotid gland.

Keywords: BLEL; DCE-MRI; MALT lymphoma; parotid gland.

MeSH terms

Adult
Aged
Area Under Curve
Contrast Media*
Diagnosis, Differential
False Negative Reactions
False Positive Reactions
Female
Gadolinium DTPA
Humans
Image Enhancement / methods*
Lymphoma, B-Cell, Marginal Zone / diagnosis*
Lymphoproliferative Disorders / diagnosis*
Magnetic Resonance Imaging / methods*
Magnetic Resonance Imaging / statistics & numerical data
Male
Middle Aged
Parotid Diseases / diagnosis*
Parotid Neoplasms / diagnosis*
ROC Curve
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Sjogren's Syndrome / diagnosis
Time Factors
Young Adult

Substances

Contrast Media
Gadolinium DTPA