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Abstract Introduction The most common site of salivary gland tumors is the parotid gland. Computed tomography (CT), magnetic resonance imaging (MRI), and sonography are imaging modalities to differentiate benign from malignant parotid tumors. Objective The aim of this study is the evaluation of the diagnostic value of perfusion CT for differentiating histological categorization of benign and malignant parotid tumors. Methods A total of 29 patients with parotid neoplasms were enrolled in this study. Mean age and all CT perfusion variables (gradient and permeability, blood flow[BF], blood volume [BV], mean transit time [MTT], permeability surface [PS], maximum intensity projection [MIP], time-density curve [TDC], and time to peak [TTP]) were compared among three groups (malignant tumors [MTs],Warthin's tumor [WT] and pleomorphic adenomas [PA]). Results The mean age of the patients was 55.9±14.1 (26-77), and 15 of them were male (51.7%). Eleven lesions were PAs [37.9%], 8 lesions were WTs (27.6%0 and 10 lesions (34.5%) were MTs (6 acinic cell carcinomas [ACCs], 3 adenocystic carcinomas [AdCCs], and 1 mucoepidermoid carcinoma [MEC]). The mean age of the patients with WTs was 62±7.5 years; 52±14.2 for patients with Pas, and 55.2±17.2 for those with MTs (p=0.32). The mean MIP was 122.7±12.2 in WT, while it was 80.5±19.5 in PA, and 76.2±27.1 in MTs (p<0.001); The mean MIP for WT was higher than for PAs and MTs; the values of MTs and PAs were not statistically different. The average of BF, BV, and curve peak were higher inWTs in comparison with the other two groups, and curve time 2 and TTP were higher in PAs in comparison with MTs. Conclusion Based on this study, perfusion CT of the parotid gland and its parameters can distinguish between benign and malignant parotid masses.
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BACKGROUND: The efficacy of serum alanine aminotransferase (ALT) levels in predicting the severity of hepatitis C virus (HCV) infection is unclear. OBJECTIVE: To compare histologic scoring of liver pathology in patients with chronic HCV infection with normal or elevated serum ALT. METHODS: Liver biopsies were performed in patients with HCV infection and either normal (n=40) or elevated (n=76) serum ALT levels, and scored for activity and fibrosis using the modified histological activity index. RESULTS: Patients with normal ALT and elevated ALT had similar demographic features. Median (range) histological activity grade was higher in patients with elevated ALT than in those with normal ALT (6 [1-15] vs. 5 [0-11], respectively; p=0.001), as was the fibrosis stage (2 [0-6] vs. 1[0-6]; p=0.02). Two patients with normal ALT and 4 with elevated ALT had liver cirrhosis. CONCLUSIONS: Among patients with chronic HCV infection, liver lesions are milder in those with normal serum ALT levels than those with abnormal ALT levels. However, some patients with normal ALT too may have advanced liver disease.