Sonoelastography, B-mode sonography, and color Doppler sonography findings of pleomorphic adenomas and Warthin tumors of parotid gland

Yıl 2015, Cilt: 25 Sayı: 6, 329 - 336, 30.12.2015

Hasan Yerli Erkan Eşki

Öz

Objectives: This study aims to investigate the sonoelastography SE , B-mode sonography, and color Doppler sonography findings of the pleomorphic adenomas and Warthin tumors of the parotid gland. Patients and Methods: A total of 84 parotid masses 23 pleomorphic adenomas, 25 Warthin tumors in 72 patients 37 males, 35 females; mean age 59 years; range 30 to 79 years were retrospectively analyzed. For each lesion, B-mode sonography, color Doppler sonography, and SE images were evaluated. Vascularity and elasticity scores of the tumors during color Doppler sonography and SE examinations were calculated by 4-scoring method. Results: Lobulated contour and cystic areas were more common in the pleomorphic adenomas and Warthin tumors during the B-mode sonography examination p<0.05 . Peripheral vascularity was common in more than half of the pleomorphic adenoma patients, whereas central or mixed vascularity was seen in a large group of the Warthin tumor patients p<0.05 . The mean scores on color Doppler sonography examination were 1.13±0.81 for pleomorphic adenomas and 1.96±0.97 for Warthin tumors p<0.05 . The mean scores on SE examination were 2.69±0.70 for pleomorphic adenomas and 1.83±0.63 for Warthin tumors p<0.05 . Score 1 on SE examination was found in three of five Warthin tumor patients with peripheral vascularity on color Doppler sonography. Conclusion: B-mode, color Doppler and elastography examinations by sonography provide some helpful findings in the differentiation of pleomorphic adenomas and Warthin tumors.

Anahtar Kelimeler

Color Doppler sonography, parotid tumors, pleomorphic adenoma, sonoelastography, ultrasonography, Warthin tumor

Parotis bezi pleomorfik adenomları ve Warthin tümörlerinin sonoelastografi, B-mod sonografi ve renkli Doppler sonografi bulguları

Öz

Amaç: Bu çalışmada parotis bezi pleomorfik adenomları ve Warthin tümörlerinin sonoelastografi SE , B-mod sonografi ve renkli Doppler sonografi bulguları araştırıldı.Hastalar ve Yöntemler: Yetmiş iki hastada 37 erkek, 35 kadın; ort. yaş 59 yıl; dağılım 30-79 yıl toplam 84 parotis kitlesi 23 pleomorfik adenom, 25 Warthin tümörü retrospektif olarak incelendi. Her lezyon için B-mod sonografi, renkli Doppler sonografi ve SE görüntüleri değerlendirildi. Renkli Doppler sonografi ve SE incelemeleri sırasında tümörlerin damarlanması ve elastisite skorları 4 skor yöntemiyle saptandı.Bulgular: B-mod sonografik değerlendirme sırasında, pleomorfik adenomlar ve Warthin tümörlerinde, lobüle sınırlı ve kistik alanlar daha yaygındı p

Anahtar Kelimeler

Renkli Doppler sonografi, parotis tümörleri, pleomorfik adenom, sonoelastografi, ultrasonografi, Warthin tümörü

Kaynakça

• Yerli H, Ağıldere AM. Parotid gland tumors: advanced imaging technologie. In: Hayat E, editor. Cancer Imaging: Instrumentation and Applications. Vol. 2, 1st ed. London: Elsevier; 2008. p. 563-73.
• King AD, Yeung DK, Ahuja AT, Tse GM, Yuen HY, Wong KT, et al. Salivary gland tumors at in vivo proton MR spectroscopy. Radiology 2005;237:563-9.
• Magnano M, gervasio CF, Cravero L, Machetta G, Lerda W, Beltramo G, et al. Treatment of malignant neoplasms of the parotid gland.Otolaryngol Head Neck Surg 1999;121:627-32.
• Rehberg E, Schroeder HG, Kleinsasser O. Surgery in benign parotid tumors: individually adapted or standardized radical interventions?. Laryngorhinootologie 1998;77:283-8. [Abstract]
• Schick S, Steiner E, Gahleitner A, Böhm P, Helbich T, Ba-Ssalamah A, et al. Differentiation of benign and malignant tumors of the parotid gland: value of pulsed Doppler and color Doppler sonography. Eur Radiol 1998;8:1462-7.
• Howlett DC, Kesse KW, Hughes DV, Sallomi DF. The role of imaging in the evaluation of parotid disease. Clin Radiol 2002;57:692-701.
• Gritzmann N, Rettenbacher T, Hollerweger A, Macheiner P, Hübner E. Sonography of the salivary glands. Eur Radiol 2003;13:964-75.
• Martinoli C, Derchi LE, Solbiati L, Rizzatto G, Silvestri E, Giannoni M. Color Doppler sonography of salivary glands. AJR Am J Roentgenol 1994;163:933-41.
• Yabuuchi H, Fukuya T, Tajima T, Hachitanda Y, Tomita K, Koga M. Salivary gland tumors: diagnostic value of gadolinium-enhanced dynamic MR imaging with histopathologic correlation. Radiology 2003;226:345-54.
• Yerli H, Aydin E, Coskun M, Geyik E, Ozluoglu LN, Haberal N, et al. Dynamic multislice computed tomography findings for parotid gland tumors. J Comput Assist Tomogr 2007;31:309-16.
• Bhatia KS, Rasalkar DD, Lee YP, Wong KT, King AD, Yuen HY, et al. Evaluation of real-time qualitative sonoelastography of focal lesions in the parotid and submandibular glands: applications and limitations. Eur Radiol 2010;20:1958-64.
• Yerli H, Eski E, Korucuk E, Kaskati T, Agildere AM. Sonoelastographic qualitative analysis for management of salivary gland masses. J Ultrasound Med 2012;31:1083-9.
• Dumitriu D, Dudea S, Botar-Jid C, Baciut M, Baciut G. Real-time sonoelastography of major salivary gland tumors. AJR Am J Roentgenol 2011;197:924-30.
• Kim J, Kim EK, Park CS, Choi YS, Kim YH, Choi EC. Characteristic sonographic findings of Warthin's tumor in the parotid gland. J Clin Ultrasound 2004;32:78-81.
• Shimizu M, Ussmüller J, Hartwein J, Donath K, Kinukawa N. Statistical study for sonographic differential diagnosis of tumorous lesions in the parotid gland. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:226-33.
• Zajkowski P, Jakubowski W, Białek EJ, Wysocki M, Osmólski A, Serafin-Król M. Pleomorphic adenoma and adenolymphoma in ultrasonography. Eur J Ultrasound 2000;12:23-9.
• Yuan WH, Hsu HC, Chou YH, Hsueh HC, Tseng TK, Tiu CM. Gray-scale and color Doppler ultrasonographic features of pleomorphic adenoma and Warthin's tumor in major salivary glands. Clin Imaging 2009;33:348-53.
• Sriskandan N, Hannah A, Howlett DC. A study to evaluate the accuracy of ultrasound in the diagnosis of parotid lumps and to review the sonographic features of parotid lesions - results in 220 patients. Clin Radiol 2010;65:366-72.
• Bozzato A, Zenk J, Greess H, Hornung J, Gottwald F, Rabe C, et al. Potential of ultrasound diagnosis for parotid tumors: analysis of qualitative and quantitative parameters. Otolaryngol Head Neck Surg 2007;137:642-6.
• Ophir J, Céspedes I, Ponnekanti H, Yazdi Y, Li X. Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging 1991;13:111-34.
• Gao L, Parker KJ, Lerner RM, Levinson SF. Imaging of the elastic properties of tissue--a review. Ultrasound Med Biol 1996;22:959-77.
• Chen EJ, Adler RS, Carson PL, Jenkins WK, O'Brien WD Jr. Ultrasound tissue displacement imaging with application to breast cancer. Ultrasound Med Biol 1995;21:1153-62.
• Itoh A, Ueno E, Tohno E, Kamma H, Takahashi H, Shiina T, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology 2006;239:341-50.
• Yerli H, Yilmaz T, Kaskati T, Gulay H. Qualitative and semiquantitative evaluations of solid breast lesions by sonoelastography. J Ultrasound Med 2011;30:179-86.