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

Affiliations
  • 1Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan. ogura@ngt.ndu.ac.jp
  • 2Department of Oral and Maxillofacial Surgery, The Nippon Dental University Niigata Hospital, Niigata, Japan.
  • 3Department of Pathology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan.

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

  • 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.

  • 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.

  • 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.

  • 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).

  • 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.

  • 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.

  • 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.

  • 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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