RT Journal Article
SR Electronic
T1 Diagnostic Role of Diffusion-Weighted and Dynamic Contrast-Enhanced Perfusion MR Imaging in Paragangliomas and Schwannomas in the Head and Neck
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1839
OP 1846
DO 10.3174/ajnr.A7266
VO 42
IS 10
A1 Ota, Y.
A1 Liao, E.
A1 Capizzano, A.A.
A1 Kurokawa, R.
A1 Bapuraj, J.R.
A1 Syed, F.
A1 Baba, A.
A1 Moritani, T.
A1 Srinivasan, A.
YR 2021
UL http://www.ajnr.org/content/42/10/1839.abstract
AB BACKGROUND AND PURPOSE: Distinguishing schwannomas from paragangliomas in the head and neck and determining succinate dehydrogenase (SDH) mutation status in paragangliomas are clinically important. We aimed to assess the clinical usefulness of DWI and dynamic contrast-enhanced MR imaging in differentiating these 2 types of tumors, as well as the SDH mutation status of paragangliomas.MATERIALS AND METHODS: This retrospective study from June 2016 to June 2020 included 42 patients with 15 schwannomas and 27 paragangliomas (10 SDH mutation-positive and 17 SDH mutation-negative). ADC values, dynamic contrast-enhanced MRI parameters, and tumor imaging characteristics were compared between the 2 tumors and between the mutation statuses of paragangliomas as appropriate. Multivariate stepwise logistic regression analysis was performed to identify significant differences in these parameters.RESULTS: Fractional plasma volume (P ≤ .001), rate transfer constant (P = .038), time-to-maximum enhancement (P < .001), maximum signal-enhancement ratio (P < .001) and maximum concentration of contrast agent (P < .001), velocity of enhancement (P = .002), and tumor characteristics including the presence of flow voids (P = .001) and enhancement patterns (P = .027) showed significant differences between schwannomas and paragangliomas, though there was no significant difference in ADC values. In the multivariate logistic regression analysis, fractional plasma volume was identified as the most significant value for differentiation of the 2 tumor types (P = .014). ADC values were significantly higher in nonhereditary than in hereditary paragangliomas, while there was no difference in dynamic contrast-enhanced MR imaging parameters.CONCLUSIONS: Dynamic contrast-enhanced MR imaging parameters show promise in differentiating head and neck schwannomas and paragangliomas, while DWI can be useful in detecting SDH mutation status in paragangliomas.AUCarea under the curveDCEdynamic contrast-enhancedEESextravascular extracellular spaceKeprate transfer constant between EES and blood plasma per minuteKtransvolume transfer constant between EES and blood plasma per minuteSDHsuccinate dehydrogenaseSERsignal-enhancement ratioTICtime-intensity curveTMEtime-to-maximum enhancementVeEES volume per unit tissue volumeVpblood plasma volume per unit tissue volume