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HEAD AND NECK

MR Imaging of Salivary Duct Carcinoma

Ken Motooria, Yumiko Iidab, Yuichirou Nagaic, Seiji Yamamotoa, Takuya Uedaa, Hiroyuki Funatsua, Hisao Itoa and Okamoto Yoshitakab

a Department of Radiology, Chiba University Hospital, Chiba City, Chiba, Japan
b Department of Otolaryngology, Chiba University Hospital, Chiba City, Chiba, Japan
c Department of Molecular Pathology, Chiba Postgraduate School of Medicine, Chiba City, Chiba, Japan

Address correspondence to Ken Motoori, MD, Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan

BACKGROUND AND PURPOSE: Salivary duct carcinoma (SDC) is regarded as a high-grade malignancy in the current classification of salivary gland neoplasms. The aim of our study was to describe the MR imaging features of SDC.

METHODS: Nine patients with SDC underwent MR imaging study. The apparent diffusion coefficient (ADC) values of SDCs were measured from diffusion-weighted images. Time–signal intensity curves (TICs) of the tumors on dynamic MR images were plotted, and washout ratios were also calculated. TICs were divided into four types: type A, curve peaks <120 seconds after administration of contrast material with high washout ratio (≥30%); type B, curve peaks <120 seconds with low washout ratio (<30%); type C, curve peaks >120 seconds; type D, nonenhanced. We correlated the MR findings of SDC with the pathologic findings.

RESULTS: All tumors had ill-defined margins and showed low to moderately high signal intensity for contralateral parotid gland on T2-weighted images. The average of the ADC values of the SDCs was 1.16 ± 0.14 [SD] x 10–3mm2/s. Seven of nine (78%) tumors had type B enhancement. On the other hand, six of nine (67%) tumors with rich fibrotic tissue also had type C enhancement.

CONCLUSION: The findings of ill-defined margin, early enhancement with low washout ratio (type B), and low ADC value (1.22 x 10–3mm2/s) were useful for suggesting malignant salivary gland tumors. Although it was reported that type C enhancement was specific for pleomorphic adenoma, SDC frequently has type C-enhanced focus.




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