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Speekselkliertumoren Aart I. Issa
Overzicht ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
 
 
 
 
Modaliteiten ,[object Object],[object Object],[object Object]
Sequenties Richting STIR Axiaal T1 SE  Axiaal PD/T2 TSE Axiaal Post-contrast Post-contrast T1 SE  Axiaal T1 SE FS Coronaal
Beoordeling ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pleiomorf adenoom ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pleiomorf adenoom ,[object Object],[object Object],[object Object],[object Object]
80% regel van glandula parotis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pleiomorf adenoom ,[object Object],[object Object],T1
Pleiomorf adenoom ,[object Object],[object Object],[object Object],[object Object],[object Object],T1+C
Pleiomorf adenoom ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
T2 T1 STIR T1+C
T1 T1+C STIR
Warthin tumor ,[object Object],[object Object],[object Object],[object Object]
Warthin tumor ,[object Object],[object Object],[object Object],[object Object],[object Object]
Warthin tumor ,[object Object],[object Object],[object Object]
Warthin tumor ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],T2
STIR T1 T2 T1+C PET
T1 T2 T1+C
Parotis Schwannoom ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
T2 T2 T1+C
Parotis Mucoepidermoid Carcinoom ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mucoepidermoid carcinoma of the parotid gland. Yousem D M et al. Radiology 2000;216:19-29 ©2000 by Radiological Society of North America T2
Mucoepidermoid carcinoma of the parotid gland. Yousem D M et al. Radiology 2000;216:19-29 ©2000 by Radiological Society of North America T1+C
Mucoepidermoid carcinoma of the parotid gland. Yousem D M et al. Radiology 2000;216:19-29 ©2000 by Radiological Society of North America CECT
Parotis Adenoid Cysteus Carcinoom ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
T1 T1 STIR
T2 T1 T1
Perineural infiltration of cranial nerve VII by adenoid cystic carcinoma. Yousem D M et al. Radiology 2000;216:19-29 ©2000 by Radiological Society of North America T1
Parotis Maligne Mixed Tumor ,[object Object],[object Object],[object Object],[object Object],[object Object]
Parotis Non Hodgkin Lymfoom ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
T1 T2 STIR T1+C T1+C PET
T1 T2 PD
Metastasen ,[object Object],[object Object],[object Object]
Behandeling ,[object Object],[object Object],[object Object],[object Object],[object Object]
Samenvatting T1 T2 STIR T1+C PlA    + Scherp begrensd, homogeen aankleurend Warthin  =/  =/  - Scherp begrensd, heterogeen MECa  /=  +/- Heterogeen, onscherp begrensd, lnn ACCa  /=  + Homogeen aankleurend, (infiltratief)
Pleiomorf adenoom STIR T2 T1+C T1+C
Adenoid cysteus carcinoom T2 STIR T1+C
Whartin T2 T1 T1+C STIR
Parotis Mucoepidermoid Carcinoom STIR T1+C T1
Whartin T1 PD T2
Parotis Adenoid Cysteus Carcinoom T1 T1+C T1+C
Pleiomorf adenoom T1 T1 T1+C T2
Pleiomorf adenoom T2 T1 T1+C CECT
Pleiomorf adenoom T1 STIR T1+C
Whartin T2 STIR T1 T1+C
Conclusie T1 T2 STIR T1+C PlA    + Scherp begrensd, homogeen aankleurend Warthin  =/  =/  - Scherp begrensd, heterogeen MECa  /=  +/- Heterogeen, onscherp begrensd, lnn ACCa  /=  + Homogeen aankleurend, (infiltratief)
Literatuur ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Met dank aan ,[object Object],[object Object],[object Object]

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Speekselkliertumoren

Editor's Notes

  1. BMT
  2. BMT
  3. Whartin
  4. Mucoepidermoid carcinoma of the parotid gland. (a) Transverse T2-weighted SE (3,000/90) MR image shows an intermediate-signal-intensity mass (arrow) slightly lower in intensity than that of the native parotid tissue. (b) The ill-defined nature of the mass (arrow) was exemplified by the fuzzy margins on this transverse, contrast-enhanced, fat-saturated, T1-weighted SE (600/30) MR image. The diagnosis was high-grade mucoepidermoid carcinoma.
  5. Mucoepidermoid carcinoma of the parotid gland. (a) Transverse T2-weighted SE (3,000/90) MR image shows an intermediate-signal-intensity mass (arrow) slightly lower in intensity than that of the native parotid tissue. (b) The ill-defined nature of the mass (arrow) was exemplified by the fuzzy margins on this transverse, contrast-enhanced, fat-saturated, T1-weighted SE (600/30) MR image. The diagnosis was high-grade mucoepidermoid carcinoma.
  6. Mucoepidermoid carcinoma of the parotid gland. Transverse CT scan shows an ill-defined mass (C) that has less attenuation than that of enhancing parotid tissue in the right parotid gland. The attenuation of this mass is the same as that of the pleomorphic adenoma in Figure 2 and less than that of the carcinoma in Figure 6.
  7. ca
  8. Perineural infiltration of cranial nerve VII by adenoid cystic carcinoma. (a) Transverse T1-weighted SE (600/11, two signals acquired) MR image shows that the right parotid mass (m) enters the notch of the stylomastoid foramen (arrow). (b) Coronal, gadolinium-enhanced T1-weighted SE (600/17, one signal acquired) MR image shows vertical extension of the enhancing tumor (arrows) through the stylomastoid foramen (line is at the plane of transverse image in a).
  9. NHL MALT
  10. lymfoom
  11. BMT
  12. Adenoid cysteus carcinoom Jongeman met immobiele zwelling ter plaatse van parotis rechts van 2 cm.Parotistumor? Oppervlakkig / diepe kwab? Relatie mandibula? Lymfeklieren?Maligniteit?  MRI HALS verslag:Onderzoek volgens parotisprotocol. Pathologische signaalintensiteit op deSTIR gewogen opnamen in de oppervlakkige kwab van de glandula parotisrechts met uitbreiding in het achterste deel van de m.masseter. Op deT1-gewogen opnamen lijkt de hele masseter groter te zijn dan decontralaterale en met iets verlaagde signaalintensiteit. Op depost-contrastopnamen kleurt de laesie in de parotis en achter in demasseter aan. Geen uitbreiding in de mandibula, pterygoidspieren ofparafaryngeale ruimte. Normaal aspect van de cutis en subcutis beideparotis. Kleine retrofaryngeale lymfeklieren beiderzijds, niet pathologischvergroot, verder geen pathologische vergrote lymfeklieren.CONCLUSIE:Massa ter hoogte van de parotis, oppervlakkige kwab, en de masseter rechts.Radiologisch zijn er kenmerken voor een maligne proces meest waarschijnlijkuitgaande van de parotis, mogelijk ook uitgaande van de masseter. Geenbotaantasting.
  13. Whartin
  14. mucoepidermoidca
  15. Whartin
  16. Grootcellig adenocarcinoom Verslag MRI hoofdhals.Er werd een onderzoek verricht van de hoofd-hals regio met aanvullende opnamen post-Gadolinium ter plaatse van de sinus cavernosis in coronale en transversale richting. Ter plaatse van de linker glandula parotis is een zeer forse massa zichtbaar welke naar ventraal in de masseter loge links uitbreidt. Massa lijkt ook links subcutaan uit te breiden. Subcutaan is er enige tekening zichtbaar en tevens een verdikte opperhuid. Geen duidelijke ingroei in de linker mandibula. Geringe ingroei is op deze opnamen niet uit te sluiten. Afstand tot schedelbasis bedraagt 12.5 mm. Er is geen perineurale tumoruitbreiding zichtbaar ter plaatse van de Nervus V3 in de richting van het foramen ovale. Er lijkt wel sprake van de trage flow in arterie carotis links met vertraagde flow en mogelijke partiele trombossering, waardoor deze aankleurt. Dit wordt bevestigd door het media-infarct links. In de hals zijn links midjugulair en subdigastrisch 5-tal vergrote klieren en op subdigastrisch, midjugulair en laagjugulair niveau zichtbaar waarvoor graag echogeleid onderzoek met punctie. Conclusie.Forse massa uitgaande van de glandula parotis links met doorgroei in masseter links. Geen duidelijke invasie van de mandibula met destructie. Geringe invasie is niet uit te sluiten. Geen perineurale tumoruitbreiding. Aantal fors vergrote klieren links waarvoor graag echogeleid onderzoek met punctie.
  17. BMT
  18. BMT
  19. BMT
  20. Whartin