Imaging Sci Dent.  2020 Mar;50(1):73-79. 10.5624/isd.2020.50.1.73.

Strain elastography of palatal tumors in conjunction with intraoral ultrasonography, computed tomography, and magnetic resonance imaging: 2 case reports

• Ogura I
• Toshima H
• Akashiba T
• Ono J
• Okada Y

• KMID: 2471848
• DOI: http://doi.org/10.5624/isd.2020.50.1.73

Abstract

Computed tomography (CT) and magnetic resonance imaging (MRI) can be useful for the evaluation of palatal lesions, and strain elastography (performed together with intraoral ultrasonography) is a relatively new sonographic imaging modality. This report describes 2 clinical cases in which strain elastography was used to assess palatal tumors in conjunction with intraoral ultrasonography, CT, and MRI. In the first case, diagnosed as a myoepithelioma, the strain was determined to be 0.000% (strain of normal tissue, 0.556%). In the second case, diagnosed as an adenoid cystic carcinoma, the determined strain was 0.000% (strain of normal tissue, 1.077%). Therefore, we conclude that intraoral strain elastography can be useful for evaluating palatal lesions.

Keyword

Palatal Neoplasms; Ultrasonography; Elasticity Imaging Techniques

MeSH Terms

Carcinoma, Adenoid Cystic
Elasticity Imaging Techniques*
Magnetic Resonance Imaging*
Myoepithelioma
Palatal Neoplasms
Ultrasonography*

Figure

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  Fig. 1 Ultrasonography of a myoepithelioma of the palate in a 54-year-old woman. A and B. Color Doppler ultrasonography. C. Strain elastography. D. The strain values of the normal tissue and tumor in the palate were R and T1–3, respectively.

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  Fig. 2 Computed tomography (CT) of a myoepithelioma of the palate in a 54-year-old woman (arrows). A. Coronal soft-tissue algorithm CT image. B. Sagittal soft-tissue algorithm CT image. C. Coronal contrast-enhanced CT image. D. Sagittal contrast-enhanced CT image. E. Coronal bone-tissue algorithm CT image. F. Sagittal bone-tissue algorithm CT image.

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  Fig. 3 Magnetic resonance image of a myoepithelioma of the palate in a 54-year-old woman (arrows). A. Coronal T1-weighted image. B. Coronal T2-weighted image. C. Coronal post-contrast T1-weighted image.

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  Fig. 4 Specimen and histopathological exam of a myoepithelioma of the palate in a 54-year-old woman. On the cut surface of the tumor (A) and on the low-magnification view (B) of the surgical specimen (hematoxylin and eosin [H&E] stain ×1 magnification; scale bar, 5 mm), a thin, discrete fibrous capsule was visible (arrows). C. Epithelioid, spindle, and plasmacytoid neoplastic myoepithelial cells were observed (H&E stain ×40 magnification; scale bar, 50 µm).

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  Fig. 5 Ultrasonography of an adenoid cystic carcinoma of the palate in a 70-year-old woman. A and B. Color Doppler ultrasonography. C. Strain elastography. D. The strain values of the normal tissue and tumor in the palate were R and T1-3, respectively.

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  Fig. 6 Computed tomography (CT) of an adenoid cystic carcinoma of the palate in a 70-year-old woman (arrows). A. Coronal soft-tissue algorithm CT image. B. Sagittal soft-tissue algorithm CT image. C. Coronal contrast-enhanced CT image. D. Sagittal contrast-enhanced CT image. E. Coronal bone-tissue algorithm CT image. F. Sagittal bone-tissue algorithm CT image.

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  Fig. 7 Magnetic resonance imaging of an adenoid cystic carcinoma of the palate in a 70-year-old woman (arrows). A. Coronal T1-weighted image. B. Coronal T2-weighted image. C. Coronal post-contrast T1-weighted image.

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  Fig. 8 Specimen and histopathological exam of an adenoid cystic carcinoma of the palate in a 70-year-old woman. In the coronal segment (A) of the right maxillary first molar (real view) and the low-magnification view (B) of the surgical specimen (H&E stain ×1; scale bar, 5 mm), the tumor showed aggressive bone destruction and extension into the maxillary sinus (*) and nasal cavity (★). C. Cribriform and tubular patterns were observed (H&E stain ×40; scale bar, 50 µm).

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