Aim: The aim of this prospective study is to identify quantitative intravoxel incoherent motion and dynamic contrast-enhanced magnetic resonance imaging parameters of the most frequent benign parotid tumors, compare their utility and diagnostic accuracy. Methods: The study group consisted of 52 patients with 64 histopathologically confirmed parotid focal lesions. Parametric maps representing apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (FP) and transfer constant (Ktrans), reflux constant (Kep), extra-vascular extra-cellular volume fraction (Ve), and initial area under curve in 60 s (iAUC) have been obtained from multiparametric MRI. Results: Statistically significant (p < 0.001) inter-group differences were found between pleomorphic adenomas (PA) and Warthin tumors (WT) in all tested parameters but iAUC. Receiver operating characteristic curves were constructed to determine the optimal cut-off levels of the most significant parameters allowing differentiation between WT and PA. The Area Under the Curve (AUC) values and thresholds were for ADC: 0.931 and 1.05, D: 0.896 and 0.9, Kep: 0.964 and 1.1 and Ve: 0.939 and 0.299, respectively. Lesions presenting with a combination of ADC, D, and Ve values superior to the cut-off and Kep values inferior to the cut-off are classified as pleomorphic adenomas. Lesions presenting with combination of ADC, D, and Ve values inferior to the cut-off and Kep values superior to the cut-off are classified as Warthin tumors. Conclusions: DWI, IVIM and quantitative analysis of DCE-MRI derived parameters demonstrated distinctive features of PAs and WT and as such they seem feasible in differentiation of benign parotid gland tumors.

Background: Haemochromatosis (HCH), a common genetic disorder with variable penetrance, results in progressive but understudied iron overload. We prospectively evaluated organ iron loading and cardiac function in a tertiary center HCH cohort. Methods: 42 HCH patients (47 ± 14 years) and 36 controls underwent laboratory workup and cardiac magnetic resonance (CMR), including T1 and T2* mapping. Results: Myocardial T2* (myoT2*), myocardial T1 (myoT1) and liver T2* (livT2*) were lower in patients compared to controls (33 ± 4 ms vs. 36 ± 3 ms [p = 0.004], 964 ± 33 ms vs. 979 ± 25 ms [p = 0.028] and 21 ± 10 ms vs. 30 ± 5 ms [p < 0.001], respectively). MyoT2* did not reach the threshold of clinically significant iron overload (<20 ms), in any of the patients. In 22 (52.4%) patients, at least one of the tissue parameters was reduced. Reduced myocardial T2* and/or T1 were found in 10 (23.8%) patients, including 4 pts with normal livT2*. LivT2* was reduced in 18 (42.9%) patients. MyoT1 and livT2* inversely correlated with ferritin (rs = −0.351 [p = 0.028] and rs = −0.602 [p < 0.001], respectively). LivT2* by a dedicated sequence and livT2* by cardiac T2* mapping showed good agreement (ICC = 0.876 p < 0.001). Conclusions: In contemporary hemochromatosis, significant myocardial iron overload is rare. Low myocardial T2* and/or T1 values may warrant closer follow-up for accelerated myocardial iron overload even in patients without overt liver overload. Cardiac T2* mapping sequence allows for liver screening at the time of CMR.

Background: Cardiac involvement (CI) in systemic sclerosis (SSc) is frequently subclinical and it can be identified in up to 80% of autopsied hearts. If present, symptoms are related to adverse prognosis, and CI represents one of the predominant causes of SSc-related mortality. Methods: A total of 20 patients with a diagnosis of SSc were included and followed up, and 37 volunteers were included and subsequently scanned on a 1.5T MR system. Results: Overall, thirteen (65%) patients had one or more abnormal cardiac findings in CMR (defined as CI[+]), of which in seven (35%), baseline ECGs and standard echocardiograms were normal or unspecific. Compared to healthy volunteers, SSc patients had a lower LVEF% (56.6% vs. 61.6%; p = 0.0131), longer T1 (1028.3 ms vs. 993.1 ms; p = 0.0049) and T2 relaxation times (48.24 ms vs. 43 ms p = 0.0011), and higher extracellular volume (ECV, 27.9% vs. 26.0%; p = 0.0112). However, no difference in CMR-derived, feature-tracking GLS values between patients and healthy controls was found (−15.5[2,8] vs. −16.3[1,1], respectively, p = 0.11). Over 3.4 (1.9–5.5) years, three patients (15%) died, and two others (10%) sustained major cardiac complications. Conclusions: Cardiac magnetic resonance with modern quantitative techniques reveals subtle morpho-functional alterations and thus allows for early diagnosis of myocardial involvement in systemic sclerosis. Our findings emphasize the need for extended diagnostic workup in these patients and demonstrate the ability of cardiac MR to select patients requiring closer follow-up and/or treatment decisions.