Article Figures & Data
Figures
- FIG 1.
A 41-year-old woman with a schwannoma in the left parotid space. A, T2-weighted image shows a hyperintense mass in the left parotid gland. B and C, Contrast-enhanced T1-weighted image shows homogeneous enhancement. D, Mean ADC and normalized mean ADC are 1.15 × 10−3 mm2/s and 1.48, respectively. E and F, Vp and TME are demonstrated. G, The TIC demonstrates a low peak enhancement with a long time-to-peak.
- FIG 2.
A 26-year-old man positive for the SDHB mutation with a paraganglioma in the left jugular foramen. A, T2-weighted image shows a heterogeneous irregular mass in the left jugular foramen. B and C, Contrast-enhanced T1-weighted images show a heterogeneous, enhancing mass with a vascular flow void. D, Mean ADC and normalized mean ADC are 1.12 × 10−3 mm2/s and 1.48. E and F, Vp and TME are demonstrated. G, The TIC demonstrates a higher peak enhancement with a shorter time-to-peak compared with Fig 1.
- FIG 3.
A 34-year-old woman with a schwannoma in the right jugular foramen. A, The permeability map shows a heterogeneously enhancing mass in the right jugular foramen. B and C, The values of Vp and TME are 0.03 and 219, respectively. D, The TIC demonstrates a low peak enhancement with a long time-to-peak compared with Fig 2.
- FIG 4.
A 70-year-old man negative for the SDH mutation with a paraganglioma in the right jugular foramen. A, The permeability map shows a homogeneously enhancing mass in the right jugular foramen. B and C, The values of Vp and TME are 0.53 and 27.7, respectively. D, The TIC demonstrates a high peak enhancement with a short time-to-peak compared with Figs 1 and 3.
- FIG 5.
Receiver operating characteristic curves of Vp, TME, and peak enhancement. The AUCs of Vp, TME, and peak enhancement were 0.99, 0.92, and 0.89 with cutoff values of 0.30, 62.8, and 277 seconds, respectively.
Tables
- Table 1:
Patient demographics and tumor characteristics in schwannomas and paragangliomasa
Schwannomas(n = 15) Paragangliomas(n = 27) P Value No. 15 27 NA Sex (male/female) 5:10 7:20 .73 Age (yr) 42.2 (SD, 15.1) 48.2 (SD, 17.2) .27 Maximum diameter (mm) 31.4 (SD, 15.4) 32.3 (SD, 15.6) .76 Presence of vascular flow voids (salt-and-pepper appearance) 2/15 18/27 .001b Cystic or necrotic change 5/15 14/27 .34 Enhancement pattern (homogeneous enhancement/total) 10/15 8/27 .027b Location (head lesion/total) 5/15 11/27 .75 - Table 2:
ADC values and DCE-MR imaging dynamic parameters of schwannomas and paragangliomasa
Schwannomas
(n = 15)Paragangliomas
(n = 27)P Value Mean ADC (× 10–3 mm2/s) 1.17 (SD, 0.31) 1.12 (SD, 0.26) .56 Normalized mean ADC 1.54 (SD, 0.43) 1.45 (SD, 0.37) .53 Quantitative values Vp 0.06 (0.03–0.12) 0.40 (0.34–0.54) <.001b Ve 0.42 (0.25–0.77) 0.28 (0.16–0.47) .38 Kep (min–1) 0.58 (0.36–0.67) 1.02 (0.43–2.27) .038a Ktrans (min-–1) 0.15 (0.11–0.26) 0.31 (0.13–0.74) .16 Semiquantitative values AUC (mmol.min/L) 5.6 × 104 (1.95 × 104–1.55 × 105) 7.0 × 104 (3.8 × 104–4.1 × 105) .08 Peak enhancement 137 (75–220) 294 (266–300) <.001b Wash-in 1.4 (0.74–3.8) 7.26 (2.54–42.6) .002b Washout 3.4 (0.77–8.4) 1.0 (0.42–6.0) .35 SER 53.9 (47–90) 146 (112–211) <.001b TME (sec) 160 (108–239) 36.2 (27.7–77.4) <.001b - Table 3:
Diagnostic performance of dynamic parameters in differentiating schwannomas and paragangliomas
Vp Kep Peak Enhancement Wash-In SER TME (Sec) Cutoff 0.30 0.86 277 6.29 135 62.8 Sensitivity 0.91 0.67 0.74 0.63 0.89 0.72 Specificity 1.00 0.87 1.00 0.93 0.73 1.00 PPV 1.00 0.90 1.00 0.94 0.86 1.00 NPV 0.88 0.59 0.68 0.58 0.79 0.68 Accuracy 0.95 0.74 0.83 0.74 0.83 0.83 AUC 0.99 0.70 0.89 0.80 0.86 0.92 Note:—PPV indicates positive predictive value; NPV, negative predictive value.
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