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 (

P

＜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.