The role of magnetic resonance imaging and magnetic resonance sialography in the evaluation of salivary sialolithiasis : radiologic-endoscopic correlation

Purpose: To evaluate the role of magnetic resonance imaging (MRI) and MR sialography in salivary gland calculi in correlation with sialendoscopy. Material and methods: In this prospective study, pre-therapeutic MRI was performed for patients with clinically suspected sialolithiasis. In addition, sialendoscopy with or without surgery was performed. The detectability, number, size, and location of calculi (distance of obstruction from the ostium and masseter line) and the condition of the main duct at MRI were reported. Agreement between the 2 readers was confirmed for all MRI findings. Data regarding the detectability, number, and size of calculi were correlated with endoscopy. Results: There was excellent agreement between the 2 readers regarding the detection and number of calculi at MR sialography (κ = 1, p < 0.001). As regards MRI measurements, excellent interclass correlation was found between the 2 readers regarding size of calculi, distance of calculi from the ostium, and distance from the masseter line (κ = 0.98, 0.98, 0.97, respectively; p < 0.001). In correlation with sialendoscopy, MRI was false negative in 1 patient, and it missed 1 calculus in 3 patients with multiple calculi. There was no statistically significant difference between the size of calculi detected by MRI and true size of calculi retrieved by sialendoscopy. Conclusion: MR sialography is an accurate modality for diagnosis of the presence, size, and location of sialolithiasis and offers accurate ductal mapping for sialendoscopists

Role of dynamic contrast enhanced and diffusion weighted MRI in the differentiation between post treatment changes and recurrent laryngeal cancers

AbstractPurposeTo examine the potential of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI), diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) for differentiating recurrent laryngeal cancer from post treatment changes.Materials and methodsA prospectively designed study was conducted on 50 patients having laryngeal cancers treated by surgery or chemoradiotherapy or both. In all subjects, conventional MRI sequences were performed apart from DWI and DCE sequences. Mean ADC values in benign and malignant groups were compared. Different patterns of dynamic curves were compared qualitatively and semiquantitatively using washout ratio (WR), time to peak (Tpeak) and maximum contrast enhancement in both groups.ResultsADC cutoff value of 0.9667×10−3mm2/s effectively differentiated benign and malignant lesions with 100% sensitivity, 74.2% specificity and 84% accuracy. Mean WR in benign or inflammatory lesions was significantly lower than in malignant tumors. A cutoff value of WR −7.995 can differentiate benign post treatment changes from malignant recurrence with sensitivity of 96.6%, specificity of 81.2% and overall accuracy of 88.9%.ConclusionsADC mapping and DCE MRI are effective MRI tools for the differentiation of benign post treatment changes from malignant recurrence in laryngeal cancer

Intracranial neoplastic lesions of the trigeminal nerve: How MRI can help

Objective: The aim of this study was to highlight the role of MRI in detecting and diagnosing trigeminal nerve neoplastic lesions. Patients and methods: 56 patients included in our study presented with trigeminal symptoms with or without other neurological symptoms, subjected to conventional MRI sequences and 3D sequences as (CISS) and T1 magnetization-prepared rapid acquisition gradient echo (MP-RAGE). The inclusion criteria included patients with intracranial neoplastic lesions involving the trigeminal nerve and/or its branches. Results: 28 patients met our inclusions criteria and subjected to statistical analysis; 19 patients were females and 9 were males ranging between 15 and 70 years with a mean age of 47.5 years. 14 lesions were benign and 14 were malignant, and were distributed according to final diagnosis as meningiomas (10 cases), lymphoma (6 cases), deposits (4 cases), nasopharyngeal carcinoma (4 cases) schwannoma (3 cases), and neurofibroma (one case). The most frequent involved segments of the trigeminal nerve was simultaneous involvement of both Meckel’s cave and cavernous sinus in nine cases (32%). Conclusions: MRI is very helpful in demonstrating the whole intra-cranial course of the trigeminal nerve and in diagnosing various neoplastic lesions involving the nerve, and thus providing full roadmap before management