| Purpose:The qualitative parameters of magnetic resonance imaging were used to differentiate parotid gland lymphoma from pleomorphic adenoma,providing reliable imaging diagnosis basis for clinical differentiation of parotid gland tumor and selection of surgical plan.Methods:Postoperative pathologically confirmed parotid gland tumors in our hospital from January 2019 to November 2021 were collected,including 37 cases of adenoma and 40 cases of pleomorphic adenoma.All patients underw ent MRI examination.General data of patients with adenoma and pleomorphic adenoma were analyzed,including age,sex,smoking history,and quantitative MRI data:tumor location,shape,boundary,maximum diameter,MRI signal,presence or absence of surrounding enlarged lymph nodes,tumor-spinal signal intensity ratio（SIR）,and ADC value.Receiver operating characteristic curve（ROC）was calculated by analyzing the tumor-spinal cord signal intensity ratio and ADC value of parotid gland lymphoma and pleomorphic adenoma,and the area under RO C curve（A UC）was calculated.The sensitivity and specificity were determined according to the calculated critical value.All data were analyzed by SPSS26.0 softw are.Two independent sample T test was used for inter-group comparison of measurement data subject to normal distribution,and rank sum test was used for measurement data subject to skewness distribution.χ2 test was used for counting data.P<0.05considered that the difference was statistically significant.Results:Of the 37 patients with adenoma,33 were males and 4 were females.Among the 40 patients with pleomorphic adenoma,there were 20 males and20 females.There were significant differences in gender between the two groups（P<0.001）.The smoking rate of lymphoma patients was significantly higher than that of polyadenoma patients,and the difference was statistically significant（P<0.001）.The mean age of onset of lymphoma was59.59±9.98 years,and that of pleomorphic adenoma was 45.20±9.98 years.The mean age of onset of lymphoma was higher than that of pleomorphic adenoma,and there was a significant difference between the two groups（P<0.001）.There was no significant difference in mean maximum diameter between the two groups（P>0.05）.The MRI findings of adenoma and pleomorphic adenoma showed statistically significant differences in shape,location,bilateral lesions,multiple lesions and high signal intensity on T2WI（P<0.05）,there were no significant differences in T1WI signal,location,boundary,signal uniformity and lymph node enlargement（P>0.05）.There were statistically significant differences in SIR and ADC values between adenoma and pleomorphic adenoma on T2WI,T1WI and DWI tumor/spinal cord（P<0.05）.The ratio of tumor spinal cord signal intensity and ADC value of the two groups of tumors were analyzed by ROC curve,and T2WI SIR>1.32 of tumor/spinal cord was calculated.Diagnosed as pleomorphic adenoma,the area under curve（AUC）for differentiating pleomorphic adenoma from adenocarcinoma was 0.893,the sensitivity was83.8%,and the specificity was 85.0%.T1WI tumor/spinal cord SIR<1.04The diagnosis of pleomorphic adenoma,the AUC was 0.846,the sensitivity was 97.3%,and the specificity was 55.0%.DWI tumor/spinal cord SIR<1.38 Diagnosis of pleomorphic adenoma:AUC of 0.691,sensitivity of67.6%,specificity of 70.0%,The diagnosis of pleomorphic adenoma was ADC>1.21×10-3mm2/s,and the AUC was 0.977,the sensitivity was 94.6%,and the specificity was 95.0%.Conclusion:Parotid gland lymphoma is more likely to occur in smoking elderly men,with bilateral and multifocal manifestations.MR tumor/spinal cord SIR and ADC value have important value in the differential diagnosis of parotid gland lymphoma and pleomorphic adenoma,among which ADC value is the most valuable. |
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