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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



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  		FIG 1. SDC in the left parotid gland of a 48-year-old man.

A, T2-weighted image (4000/104 [TR/TE], coronal plane) shows a tumor with ill-defined margin. The tumor shows low (arrow) to moderately high signal intensity for the contralateral parotid gland.

B, STIR image (4000/30, axial plane) also shows a hypointensity focus (arrow) in the tumor. The border of the tumor is invasive (arrowheads).

C, T1-weighted image (400/9, axial plane) shows an isointense tumor.

D, Third phase images on dynamic study (6.3/1.4, axial plane) show irregular enhancement. Marked enhanced area (region of interest 1), well-enhanced area (region of interest 2), and gradual upward enhanced area (region of interest 3) are detected.

E, Signal intensity graph shows that the washout ratio of region of interest 1 is 35% (type A) and that of region of interest 2 is 13% (type B). Time–signal intensity curves of region of interest 3 show gradual upward enhancement (type C).

F, Radical parotidectomy including facial nerve, mastoid tip, and skin was performed. Tumor extension from the cut specimen (arrowheads) is in good agreement with the MR images. The focus showing hypointensity on STIR and T2-weighted images and gradual upward enhancement on dynamic MR images corresponding to the fibrotic area (asterisk).

G, The light-optic appearance (original magnification x40) in region of interest 1 shows abundant atypical epithelial cells (white asterisks) with fibrotic stromata (black asterisks).

H, The light-optic appearance (original magnification x40) in region of interest 2 shows atypical epithelial cells (white asterisks) with fibrotic stromata and many foci of comedonecrosis (double asterisks).

I, The light-optic appearance (original magnification x40) in region of interest 3 shows dense fibrotic tissue with cellular components (white asterisk).



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  		FIG 2. SDC in the left parotid gland of a 52-year-old man. He has ipsilateral metastatic lymph nodes and contralateral reactive lymph nodes.

A, Fat-suppression T1-weighted image (340/20, axial plane) shows multiple cervical lymphadenopathies. Metastatic lymph node (arrow) is >10 mm in minimal axial diameter. Reactive lymph node (arrowhead) is <10 mm in minimal axial diameter.

B, On diffusion-weighted image (spin-echo single-shot echo-planar sequence with b factors of 0 and 1000 s/mm2), both lymph nodes show high signal intensity. The ADC value of the metastatic lymph node (region of interest 1) is 1.23 x 10–3 mm2/s and that of the reactive lymph node is 0.90 x 10–3 mm2/s.

C, Signal intensity graph shows that the washout ratio of region of interest 1 is 2% (type B) and that of region of interest 2 is 48% (type A).





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X