USEFULNESS OF MRI IN THE DIAGNOSIS OF SALIVARY GLAND PATHOLOGIES Abstract id : Iria-1099

INTRODUCTION MAJOR SALIVARY GLAND MINOR SALIVARY GLANDS -PAROTID,SUBMANDIBULAR,SUBLINGUAL MINOR SALIVARY GLANDS NUMEROUS SCATTERED THROUGHOUT UPPER AERODIGESTIVE TRACT. SALIVARY GLAND PATHOLOGIES BENIGN NON NEOPLASTIC BENIGN NEOPLASTIC MALIGNANT.

INTRODUCTION ULTRASOUND CT MRI Cheaper, widely available fine-needle aspiration (FNA) and biopsy. CT Radio- dense calculi MRI Superficial /deep parts and the facial nerve . To evaluate minor salivary gland disease Perineural spread or skull base involvement of tumor Deep spaces involvement for surgical assessment . Thin slices (3D FIESTA) – ducts can be studied .

AIM To assess the usefulness of MRI in the diagnosis of salivary gland pathologies.

84 pts with parotid gland tumors were studied. REVIEW OF LITERATURE MR Imaging of Parotid Tumors: Typical Lesion Characteristics in MR Imaging Improve Discrimination between Benign and Malignant Disease 84 pts with parotid gland tumors were studied. Histology was available for all tumors. MR imaging parameters analyzed were: signal intensity, contrast enhancement, lesion margins (well-defined versus ill-defined), lesion location (deep/superficial lobe), growth pattern (focal, multifocal, or diffuse), and extension into neighbouring structures, perineural spread, Lymphadenopathy. Christe C. Waldherr R. Hallett P. Zbaeren H. Thoeny AJNR Am J Neuroradiol 32:1202–07 􏰅 Aug 2011

Low signal intensity on T2-weighted images and postcontrast ill-defined margins of a parotid tumor are highly suggestive of malignancy.

MATERIALS AND METHODS Prospective study, May 2013- Oct 2014 24 Patients with suspected salivary gland disease 5 Excluded as follow up was not available MRI findings correlated with clinical follow up (10) and surgical/ histopathological diagnosis(9) in 19 pts

TECHNIQUE Procedure – Head first, Head neck coil, Scan covers salivary gland and neck region AXIAL– T1, T2, T2 FS,DIFFUSION,CISS,GRADIENT . CORONAL STIR SAGITTAL T2 weighted images

RESULTS

PAROTID PATHOLOGY

SUBMANDIBULAR GLAND PATHOLOGY

BENIGN NON NEOPLASTIC PAROTITIS PAROTID CYST AVM OF PAROTID BILATERAL PAROTID MICROABSCESSES RECURRENT SIALADENITIS BENIGN NEOPLASTIC PLEOMORPHIC ADENOMA SUBMANDIBULAR LIPOMA HAEMANGIOENDOTHELIOMA

DIAGNOSIS MRI FINAL Parotitis 10 Pleomorphic adenoma 3 2 Parotid cyst 1 AVM of parotid Lymphoma Haemangioendothelioma Recurrent sialadenitis Bilateral parotid microabscesses Submandibular lipoma

DISCUSSION

24 YEAR MALE WITH PAROTITIS Diffusely enlarged superficial and deep lobes of parotid T 1 hypointense T2 hyperintense

45 YEAR OLD MALE WITH PAROTID CYST Well Circumscribed T1 hypointense T2 hyperintense lesion

solid and cystic components. T1 isointense to muscles T2 hyperintense 23 YEAR OLD FEMALE WITH HAEMANGIOENDOTHELIOMA well defined lesion solid and cystic components. T1 isointense to muscles T2 hyperintense

Well circumscribed T1 hypointense T2 hyperintense mass smooth margins 38 YEAR OLD MALE WITH PLEOMORPHIC ADENOMA Well circumscribed T1 hypointense T2 hyperintense mass smooth margins

52 YEAR OLD FEMALE WITH SUBMANDIBULAR LIPOMA Well circumscribed T1 Hyperintense T2 Hyperintense Saturates on fat saturated sequences

CORRELATION Christie et al found 70% accuracy in diagnosing benign parotid lesions and 36% in malignant lesions. Our study showed an accuracy of 95% in diagnosing salivary gland pathologies.

CONCLUSION There are certain MRI characteristics for each of the common salivary gland pathologies which helps in the exact diagnosis. MRI showed an accuracy of 95% in diagnosis of salivary gland pathologies. Hence MRI is an extremely useful in the diagnosis of salivary gland pathologies.