Abstract
Background: Accurate preoperative characterization of parotid gland tumors is essential for surgical planning and facial nerve preservation.
Objective: To assess the diagnostic performance of ultrasound (US), MRI, and US-guided fine-needle aspiration (FNA) in differentiating benign from malignant parotid tumors.
Methods: A retrospective study of 95 patients who underwent preoperative imaging followed by surgical resection and histopathological confirmation. Sensitivity, specificity, and predictive values were calculated for each modality.
Results: Benign tumors predominated (93.7%), mainly pleomorphic adenomas (44.2%) and Warthin tumors (31.6%). MRI showed the highest diagnostic performance, with 83.3% sensitivity and 92.1% specificity. US demonstrated 66.7% sensitivity and 80.9% specificity, while FNA showed high specificity (92.5%) but low sensitivity (33.3%). MRI and US had high negative predictive values (98.8% and 97.3%, respectively).
Conclusion: MRI provides the best preoperative assessment for suspected malignancy. US and FNA are useful initial tools, while MRI is recommended when malignancy is suspected or FNA is inconclusive. A multimodal approach improves diagnostic accuracy.
Keywords: Parotid neoplasms; Magnetic resonance imaging; Ultrasonography; Biopsy, fine-needle; Diagnostic imaging; Diagnosis, Differential