Major salivary gland masses: comparison of MR imaging and CT

Computed tomography (CT) and magnetic resonance (MR) imaging studies were done prospectively in 21 unselected patients in whom 28 major salivary glands had pathologic changes. Blinded and final readings were used to establish the relationship of the lesion to the plane of the facial nerve (parotid masses), whether the lesion was intrinsic to the gland, and whether the lesion was aggressive. In the blinded reading, CT was superior to MR imaging in eight instances; in the final reading, however, with clinical information available, CT was superior in four cases of inflammatory salivary gland "masses." CT and MR imaging provided the same diagnostic information in all cases of salivary gland neoplasms. T1- and T2-weighted images proved of equal value in detection of salivary gland lesions, and use of both provided no additional specificity. In most cases, T1-weighted images alone provided the information necessary for surgical management. MR imaging is a reasonable first choice if a neoplasm is likely; the potential for improved tissue contrast at the margins of a tumor may be particularly useful. If a mass may be of inflammatory origin, contrast material-enhanced CT is a more reasonable first choice.