MRI and CT features of head and neck myoepithelioma: comparison with parotid pleomorphic adenoma

Q: What was the main purpose of this retrospective study?

To evaluate MRI and CT features of head and neck myoepithelioma and compare them with parotid pleomorphic adenoma.

Q: How were patients selected for MRI and CT assessment?

The study included 11 myoepithelioma and 103 parotid pleomorphic adenoma patients with histopathologic confirmation who underwent preoperative MRI; a subset of 7 and 29 patients additionally underwent preoperative CT.

Q: Which imaging findings differed significantly between myoepithelioma and pleomorphic adenoma?

Myoepithelioma showed more multinodular configuration, mild T2 hyperintensity, and focal unenhanced areas, while pleomorphic adenoma showed more marked T2 hyperintensity, higher T2 signal intensity ratios, higher ADC values, and higher likelihood of specific diffusion characteristics; contrast-enhanced CT attenuation was higher in myoepithelioma.

Sep 29, 2026

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To evaluate MRI and CT imaging characteristics of head and neck myoepithelioma and to compare them with parotid pleomorphic adenoma. A retrospective cohort included 11 histopathologically confirmed myoepithelioma patients and 103 parotid pleomorphic adenoma patients receiving preoperative MRI, with seven and 29 patients additionally undergoing preoperative CT. MRI/CT findings were compared between groups.

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Japanese Journal of Radiology (2026) 44:55–65 [https://doi.org/10.1007/s1](https://doi.org/10.1007/s1) 1604-025-01867-6 MRI and CT features of head and neck myoepithelioma: comparison with parotid pleomorphic adenoma Hiroki Kato1 · Takuya Seko1 · Hirofumi Shibata2 · Takenori Ogawa2 · Tomohiro Ando1 · Masaya Kawaguchi1 · Yoshifumi Noda1,3 · Abdelazim Elsayed Elhelaly1,4,5 · Hirohiko Imai1,6 · Masayuki Matsuo1 Received: 7 July 2025 / Accepted: 29 August 2025 / Published online: 15 September 2025 © The Author(s) 2025 Abstract Purpose To evaluate the MRI and CT features of head and neck myoepithelioma in comparison with parotid pleomorphic adenoma. Methods This retrospective study included 11 patients with histopathologically confirmed myoepithelioma of the head and neck and 103 patients with pleomorphic adenoma of the parotid gland, all of whom underwent preoperative MRI. Among them, seven patients with myoepithelioma and 29 with pleomorphic adenoma also underwent preoperative CT. MRI and CT findings were compared between the two groups. Results Multinodular configuration (27% vs. 4%), mild hyperintensity relative to the spinal cord on T2-weighted images (91% vs. 48%), and focal unenhanced areas on fat-suppressed contrast-enhanced T1-weighted images (100% vs. 47%) were significantly more frequent in myoepithelioma than in pleomorphic adenoma, respectively (p < 0.05) . In contrast, marked hyperintensity relative to the spinal cord on T2-weighted images (46% vs. 9%), higher signal intensity ratios on T2-weighted images (1.68 ± 0.47 vs. 1.40 ± 0.39), and higher apparent diffusion coefficient (ADC) values (1.68 ± 0.36 vs. 1.38 ± 0.23 × 10−3 mm2/s) were significantly more common in pleomorphic adenoma than in myoepithelioma, respectively (p < 0.05) . Contrast-enhanced CT attenuation was significantly higher in myoepithelioma than in pleomorphic adenoma (93.3 ± 10.5 vs. 59.2 ± 22.8 HU, p < 0.05) . Conclusions Although MRI and CT features of myoepithelioma and pleomorphic adenoma can overlap, the presence of a multinodular configuration, focal unenhanced areas, lower T2 signal intensity, lower ADC values, and higher contrastenhanced CT attenuation may aid in differentiating myoepithelioma from pleomorphic adenoma. Keywords Myoepithelioma · Pleomorphic adenoma · Neck · MRI · CT * Hiroki Kato [kato.hiroki.w4@f.gifu-u.ac.jp](kato.hiroki.w4@f.gifu-u.ac.jp) 1 Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan 2 Department of Otolaryngology, Gifu University, Gifu, Japan 3 Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA 02114, USA 4 Department of Frontier Science for Imaging, Gifu University, Gifu, Japan 5 Department of Food Hygiene and Control, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt 6 Innovation Research Center for Quantum Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan Introduction Myoepithelioma was formerly considered a variant of pleomorphic adenoma; however, it has been recognized as a distinct entity among salivary gland neoplasms by the World Health Organization classification in 1991. These are uncommon benign tumors, accounting for approximately 1.5% of all salivary gland tumors. They typically affect both major and minor salivary glands, with the parotid gland being the most common site (approximately 40% of cases), followed by the minor salivary glands. The incidence is similar in males and females, with cases reported across a wide age range (9–85 years), most commonly during the third decade of life. No definitive risk factors have been identified. Histopathologically, myoepitheliomas consist almost entirely of myoepithelial cells. They are classified into spindle cell, epithelioid cell, clear cell, and mixed types. However, biopsy and fine-needle aspiration cytology can be challenging due to their nonspecific features and potential for misd

FAQs

What was the main purpose of this retrospective study?

To evaluate MRI and CT features of head and neck myoepithelioma and compare them with parotid pleomorphic adenoma.

How were patients selected for MRI and CT assessment?

The study included 11 myoepithelioma and 103 parotid pleomorphic adenoma patients with histopathologic confirmation who underwent preoperative MRI; a subset of 7 and 29 patients additionally underwent preoperative CT.

Which imaging findings differed significantly between myoepithelioma and pleomorphic adenoma?

Myoepithelioma showed more multinodular configuration, mild T2 hyperintensity, and focal unenhanced areas, while pleomorphic adenoma showed more marked T2 hyperintensity, higher T2 signal intensity ratios, higher ADC values, and higher likelihood of specific diffusion characteristics; contrast-enhanced CT attenuation was higher in myoepithelioma.

Sep 29, 2026

Uploaded by Mia