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. 2017 Jan;46(1):20160257.
doi: 10.1259/dmfr.20160257. Epub 2016 Nov 15.

Diffusion-weighted MRI for differentiation between sialadenitis and pleomorphic adenoma

Guilherme T C Terra  1 , Jefferson X D Oliveira  1 , Adalsa Hernandez  2 , Silvia V Lourenço  1 , Emiko S Arita  1 , Arthur R G Cortes  1
Affiliations

Diffusion-weighted MRI for differentiation between sialadenitis and pleomorphic adenoma

Guilherme T C Terra et al. Dentomaxillofac Radiol. 2017 Jan.

Abstract

Objectives: The aim of this study was to compare apparent diffusion coefficient (ADC) values from diffusion-weighted MRI (DWI) among normal salivary glands, cases with sialadenitis and cases with pleomorphic adenoma of major salivary glands.

Methods: 22 patients (totalling 44 major salivary glands) diagnosed with either unilateral sialadenitis (on either parotid or submandibular gland) or parotid gland pleomorphic adenoma were selected. Contralateral non-affected glands (normal) were also analyzed. DW images were achieved using a spin-echo pulse sequence with a 1.5-T MRI device. Mean ADC values were compared among the three groups analyzed (contralateral normal glands, sialadenitis and pleomorphic adenoma).

Results: The mean ADC values were significantly higher in cases of parotid sialadenitis (p = 0.001), but not in cases of submandibular sialadenitis (p = 0.466), as compared with the contralateral non-affected glands. Cases of pleomorphic adenoma presented the highest ADC values of the study. In addition, one-way ANOVA test revealed a significant difference among the three groups of parotid glands analyzed.

Conclusions: Within the limitations of this study, the present results suggest that DWI allows for differentiation between parotid sialadenitis and pleomorphic adenoma.

Keywords: MRI; diffusion-weighted imaging; pleomorphic adenoma; salivary glands.

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Figures

Figure 1
Figure 1
Histological aspects of representative cases: (a) obstruction of a salivary gland excretory duct due to a calcified calculus. The periductal inflammation can be noted (haematoxylin and eosin, original magnification × 150). (b) Chronic sialadenitis in a case of lupus erythematous (haematoxylin and eosin, original magnification × 200). (c, d) Pleomorphic adenoma of the parotid gland: in (c), a nodular neoplasm surrounded by a fibrous pseudocapsule can be noted. In (d), the neoplasm is composed of spindle myoepithelial cells, ductal structures and a myxoid amorphous material (haematoxylin and eosin, original magnification × 40 and × 400, respectively).
Figure 2
Figure 2
Mean apparent diffusion coefficient (ADC) results for parotid and submandibular sialadenitis, in comparison with the contralateral normal glands of each patient; *p < 0.05, according to the Student's t-test.
Figure 3
Figure 3
Mean apparent diffusion coefficient (ADC) results for parotid normal glands, sialadenitis and pleomorphic adenoma: there is a significant difference among the three groups, according to the one-way ANOVA test (p = 0.001).
Figure 4
Figure 4
Diffusion-weighted MRI of a case of pleomorphic adenoma at the left parotid gland: mean apparent diffusion coefficient values were calculated for the selected regions of interest (ROIs) (circles).
See this image and copyright information in PMC

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