Does non-echo-planar diffusion-weighted magnetic resonance imaging have a role in assisting the clinical diagnosis of cholesteatoma in selected cases?

2018 ◽  
Vol 132 (3) ◽  
pp. 207-213 ◽  
Author(s):  
R Nash ◽  
R K Lingam ◽  
D Chandrasekharan ◽  
A Singh
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Imaging Technique ◽  
Single Shot ◽  
Resonance Imaging ◽  
Diffusion Weighted ◽  
Weighted Magnetic Resonance Imaging ◽  
Operative Findings ◽  
Clinical Records ◽  
Echo Planar

AbstractObjective:To determine the diagnostic performance of diffusion-weighted magnetic resonance imaging in the assessment of patients with suspected, but not clinically evident, cholesteatoma.Methods:A retrospective analysis of a prospectively collected database of non-echo-planar diffusion-weighted magnetic resonance imaging studies (using a half-Fourier single-shot turbo-spin echo sequence) was conducted. Clinical records were retrospectively reviewed to determine indications for imaging and operative findings. Seventy-eight investigations in 74 patients with suspected cholesteatoma aged 5.7–79.2 years (mean, 41.7 years) were identified. Operative confirmation was available in 44 ears. Diagnostic accuracy of the imaging technique was calculated using operative findings as a ‘gold standard’. Sensitivity of the investigation was examined via comparison with clinically evident cholesteatoma.Results:The accuracy of diffusion-weighted magnetic resonance imaging in assessment of suspected cholesteatoma was 63.6 per cent. The imaging technique was significantly less accurate in assessment of suspected cholesteatoma than clinically evident disease (p< 0.001).Conclusion:Computed tomography and diffusion-weighted magnetic resonance imaging may be complementary in assessment of suspected cholesteatoma, but should be used with caution, and clinical judgement is paramount.

Cholesteatoma imaging using modified echo-planar diffusion-weighted magnetic resonance imaging

2010 ◽  
Vol 125 (1) ◽  
pp. 10-12 ◽  
Author(s):  
E Flook ◽  
S Izzat ◽  
A Ismail
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Magnetic Resonance Scanner ◽  
Primary Surgery ◽  
Diffusion Weighted ◽  
Imaging Results ◽  
Weighted Magnetic Resonance Imaging ◽  
Operative Findings ◽  
Echo Planar

AbstractIntroduction:Imaging of cholesteatomas can be useful especially in cases of recurrent disease. Computed tomography scans have been recommended before primary surgery, but cholesteatoma tissue looks similar to inflammatory tissue. Diffusion-weighted magnetic resonance imaging is both sensitive and specific in detecting cholesteatoma, which appears as a bright signal on a dark background. Non-echo-planar diffusion-weighted magnetic resonance imaging is superior to routine echo-planar diffusion-weighted magnetic resonance imaging as it minimises susceptibility artefacts; however, the addition of this facility involves expensive magnetic resonance scanner upgrading.Method:To avoid the cost of such upgrading, we modified our echo-planar diffusion-weighted magnetic resonance imaging parameters and then scanned 15 consecutive cases of suspected cholesteatoma or suspected recurrent cholesteatoma.Results:Imaging results correlated well with clinical and/or operative findings.Conclusion:These results indicate that software adjustments can enable echo-planar diffusion-weighted magnetic resonance imaging to detect cholesteatomas reliably, and as effectively as non-echo-planar diffusion-weighted magnetic resonance imaging. This discovery has the potential to facilitate reliable delayed post-operative screening of canal wall up mastoidectomies, avoiding the need for a ‘second look’ procedure.

The value of non echo planar, diffusion-weighted magnetic resonance imaging for the detection of residual or recurrent middle-ear cholesteatoma

2014 ◽  
Vol 128 (7) ◽  
pp. 599-603 ◽  
Author(s):  
S Velthuis ◽  
K J van Everdingen ◽  
J J Quak ◽  
D R Colnot
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
False Negative ◽  
Resonance Imaging ◽  
Second Look ◽  
Diffusion Weighted ◽  
Middle Ear Cholesteatoma ◽  
Weighted Magnetic Resonance Imaging ◽  
Echo Planar

AbstractObjective:To determine the value of non echo planar, diffusion-weighted magnetic resonance imaging for detection of residual and recurrent middle-ear cholesteatoma after combined-approach tympanoplasty.Method:The magnetic resonance imaging findings after primary surgery for cholesteatoma were compared with intra-operative findings at ‘second-look’ surgery or with clinical follow-up findings.Results:Forty-eight magnetic resonance imaging studies were performed in 38 patients. Second-look surgery was performed 21 times in 18 patients. The remaining patients were followed up at the out-patient clinic. There were no false-positive findings with non echo planar, diffusion-weighted magnetic resonance imaging; however, there were four false-negative findings. The mean maximum diameter of recurrent cholesteatoma, as assessed using magnetic resonance imaging, was 11.7 mm (range, 4.4–25.3 mm). The sensitivity of non echo planar, diffusion-weighted magnetic resonance imaging for detecting cholesteatoma prior to second-look surgery was 0.76, with a specificity of 1.00. When clinical follow up of the non-operated ears was included in the analysis, sensitivity was 0.81 and specificity was 1.00.Conclusion:Recurrent cholesteatoma can be accurately detected using non echo planar, diffusion-weighted magnetic resonance imaging. Our study, however, also showed some false-negative results. Therefore, strict out-patient follow up is mandatory for those considering using this technique instead of standard second-look surgery.

Detection of recurrent and primary acquired cholesteatoma with echo-planar diffusion-weighted magnetic resonance imaging

2012 ◽  
Vol 126 (7) ◽  
pp. 670-676 ◽  
Author(s):  
A Evlice ◽  
Ö Tarkan ◽  
M Kiroğlu ◽  
K Biçakci ◽  
S Özdemir ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
False Negative ◽  
Resonance Imaging ◽  
Previous Surgery ◽  
Predictive Values ◽  
Diffusion Weighted ◽  
Acquired Cholesteatoma ◽  
Weighted Magnetic Resonance Imaging ◽  
Echo Planar

AbstractObjective:To evaluate the diagnostic value of echo-planar diffusion-weighted magnetic resonance imaging in pre-operative detection of suspected primary acquired, residual and/or recurrent cholesteatoma.Materials and methods:Fifty-eight chronic otitis media patients with suspected cholesteatoma were thus evaluated two weeks pre-operatively, and divided into group one (41 patients, no previous surgery, suspected primary acquired cholesteatoma) and group two (17 patients, previous surgery, scheduled ‘second-look’ or revision surgery for suspected residual or recurrent cholesteatoma). Patients' operative, histopathology and radiological findings were compared.Results:Cholesteatoma was found in 63 per cent of group one patients and 58 per cent of group two patients at surgery. Histopathological examination of surgical specimens indicated that imaging accurately predicted the presence or absence of cholesteatoma in 90 per cent of group one (37/41; 23 true positives, 14 true negatives) and 76 per cent of group two (13/17; seven true positives, six true negatives). Three patients in both groups were false negative diagnoses and one patient in both groups was a false positive. The sensitivity, specificity, and positive and negative predictive values of echo-planar diffusion-weighted magnetic resonance imaging of cholesteatoma were respectively 88, 93, 95 and 82 per cent in group one and 70, 85, 87 and 66 per cent in group two.Conclusion:Echo-planar diffusion-weighted magnetic resonance imaging is a valuable technique with high sensitivity and specificity for cholesteatoma imaging.

Detection of Postoperative Residual Cholesteatoma With Non-Echo-Planar Diffusion-Weighted Magnetic Resonance Imaging

2008 ◽  
Vol 29 (4) ◽  
pp. 513-517 ◽  
Author(s):  
Bert De Foer ◽  
Jean-Philippe Vercruysse ◽  
Anja Bernaerts ◽  
Filip Deckers ◽  
Marc Pouillon ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Diffusion Weighted ◽  
Weighted Magnetic Resonance Imaging ◽  
Echo Planar ◽  
Postoperative Residual
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