Magnetic resonance imaging differential diagnosis of Warthin's tumor from other parotid gland tumors

LUuml; Liangjing

doi:10.19732/j.cnki.2096-6210.2019.03.014

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Magnetic resonance imaging differential diagnosis of Warthin's tumor from other parotid gland tumors

更新时间：2025-12-15

- Magnetic resonance imaging differential diagnosis of Warthin's tumor from other parotid gland tumors
- Vol. 28, Issue 3, Pages: 198-205(2019)
- 作者机构：
  
  1. 上海市同仁医院，上海交通大学医学院附属同仁医院影像介入科,上海,200336
  2. 上海交通大学附属第六人民医院影像介入科,上海,200233
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2019.03.014
  CLC：
- Published Online：19 July 2019，
  
  Published：19 July 2019
- 稿件说明：
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吕良靓,王建波. 腺淋巴瘤与其他腮腺肿瘤的磁共振成像鉴别及其效能评估[J]. 肿瘤影像学, 2019, 28(3): 198-205 https://doi.

org/10.19732/j.cnki.2096-6210.2019.03.014
吕良靓,王建波. 腺淋巴瘤与其他腮腺肿瘤的磁共振成像鉴别及其效能评估[J]. 肿瘤影像学, 2019, 28(3): 198-205 https://doi. DOI： 10.19732/j.cnki.2096-6210.2019.03.014.

org/10.19732/j.cnki.2096-6210.2019.03.014 DOI：

摘要

目的：

探讨腺淋巴瘤与其他腮腺肿瘤的磁共振成像（magnetic resonance imaging，MRI）检查鉴别要点，总结规律并评估MRI诊断效能。

方法：

回顾性分析18例经手术病理学检查证实的腺淋巴瘤患者和28例其他腮腺肿瘤患者，均行MRI平扫、扩散加权成像（diffusion-weighted imaging，DWI）及MRI增强检查，分析发病年龄、性别、吸烟史及发病部位等临床资料及MRI表现差异，总结两者鉴别要点并评估MRI诊断效能。

结果：

腺淋巴瘤组男性多于女性（17/18，94.4%）；患者年龄均＞50岁；有明确吸烟史14例；多发者7例（38.9%）；多位于腮腺后下极（25/31，80.6%），大多数DWI上信号增高（23/31，74.2%）；囊性成分在T1WI上呈高信号9个（29.0%）；实性成分强化明显（23/31，74.2%），多呈快进快出（27/31，87.1%）。非腺淋巴瘤组女性居多（19/28，67.9%）；年龄多50岁（18/28，64.3%）；无明确吸烟史17例；多发者3例（10.7%）；位于腮腺后下极8个（24.2%）；少见DWI信号增高（10/33，30.3%）；囊性成分在T1WI上呈高信号者少见（2/33，6.1%）；实性成分大多强化明显（21/33，63.6%），部分呈快进快出（12/33，36.4%）。

检验及Logistic回归分析显示两组性别、年龄、吸烟史、发病数目、发病部位、DWI高信号、囊性成分T1WI高信号及快进快出样强化方面差异有统计学意义（

＜0.05），其中强化模式及DWI高信号对腺淋巴瘤诊断具有较大价值，OR值分别为101.57（95% CI：6.39~161.47）和63.89（95% CI：5.46~747.47）。

结论：

腮腺腺淋巴瘤好发于中老年吸烟男性的浅叶后下极，DWI高信号、囊性成分T1WI高信号及增强模式对腺淋巴瘤具有鉴别价值，其中DWI高信号和增强模式具有较大诊断效能。建议对于影像学诊断确切的腺淋巴瘤患者，应尽量避免手术，从而降低损伤面神经的风险。

Abstract

Objective:

To explore the main magnetic resonance imaging (MRI) signs of identifying Warthin's tumo

r from other parotid gland tumors

and evaluate the diagnostic efficiency of MRI.

Methods:

Eighteen cases with Warthin's tumor and 28 cases with other parotid gland tumors confirmed by surgery and pathology were retrospectively analyzed. All of the patients underwent routine MRI

diffusion-weighted imaging (DWI) and contrast-enhanced dynamic MRI examinations before surgeries. The data of age

sex

smoking history

tumor location and MRI performance were compared.

Results:

In Warthin's tumor group

more males (17/18

94.4%); all older than 50 years; 14 with smoking history; 7 with multiple lesions; location in parotid posterior and inferior quadrant in 25 cases (25/31

80.6%); hyperintensity on DWI (23/31

74.2%); cystic components presenting hyperintensity on T1WI in 9 cases (29.0%); obvious enhancement of solid components on T1WI (23/31

74.2%); early enhancement and early washout (27/31

87.1%). In non-Warthin's tumor group

more females (19/28

67.9%); 50 years or younger (18/28

64.3%); 17 with smoking history; only 3with multiple lesions; location in parotid posterior and inferior quadrant in 8 cases (24.2%); hyperintensity on DWI in 10 cases (10/33

30.3%); cystic components presenting hyperintensity on T1WI in 2 cases (6.1%); obvious enhancement of solid components on T1WI (21/33

63.6%); early enhancement and early washout in some lesions (12/33

36.4%). Chi-squared test and Logistic analysis showed statistical differences in sex

age

smoking history

lesion number

lesion location

high signal on DWI

hyperintensity of cystic components on T1WI and enhanced pattern (

＜0.05). Enhanced pattern and hyperintensity on DWI were useful for diagnosis and differential diagnosis of Warthin's tumor

with OR of 101.57 (95% CI: 6.39-161.47) and 63.89 (95% CI: 5.46-747.47)

respectively.

Conclusion:

Warthin's tumor tends to locate in the lower parotid lobe in middle-aged and elderly men with smoking history. Hyperintensity on DWI

hyperintensity of cystic co

mponents on T1WI

and enhanced pattern have diagnostic value for Warthin's tumor

among which hyperintensity on DWI and enhanced pattern have greater diagnostic efficiency. It is suggested that the patients with Warthin's tumor confirmed by preoperative images should avoid surgery to reduce the risk of facial nerve injuries.

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