TY - JOUR T1 - Detection of Middle Ear Cholesteatoma by Diffusion-Weighted MR Imaging: Multishot Echo-Planar Imaging Compared with Single-Shot Echo-Planar Imaging JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 1915 LP - 1918 DO - 10.3174/ajnr.A2651 VL - 32 IS - 10 AU - K. Yamashita AU - T. Yoshiura AU - A. Hiwatashi AU - H. Kamano AU - T. Dashjamts AU - S. Shibata AU - A. Tamae AU - H. Honda Y1 - 2011/11/01 UR - http://www.ajnr.org/content/32/10/1915.abstract N2 - BACKGROUND AND PURPOSE: Previous reports have shown that DWI is useful in detecting cholesteatoma. SS-EPI is the most widely used DWI technique. However, SS-EPI may have susceptibility artifacts due to field inhomogeneity in the imaging of the temporal bone region. Our purpose was to prospectively evaluate the advantage of MS-EPI for the diagnosis of middle ear cholesteatoma by comparing it with SS-EPI. MATERIALS AND METHODS: We studied 29 patients with preoperatively suspected acquired cholesteatoma. Each patient underwent an MR imaging examination including both SS-EPI and MS-EPI by using a 1.5T MR imaging scanner. Images of the 29 patients (58 temporal bones including 30 with and 28 without cholesteatoma) were reviewed by 2 independent neuroradiologists. The confidence level for the presence of cholesteatoma was graded on a scale of 0–2 (0 = none, 1 = equivocal, 2 = definite). Interobserver agreement as well as sensitivity, specificity, and accuracy were assessed for the 2 readers. RESULTS: Excellent interobserver agreement was shown for both MS-EPI (κ = 0.856) and SS-EPI (κ = 0.820). MS-EPI was associated with higher sensitivity (76.7%) and accuracy (87.9%) than SS-EPI (sensitivity = 50.0%, accuracy = 74.1%) (P < .05), while both methods showed 100% specificity. CONCLUSIONS: Compared with SS-EPI, MS-EPI improves the accuracy of the diagnosis of acquired middle ear cholesteatomas. DWIdiffusion-weighted imagingMS-EPImultishot echo-planar imagingPROPELLERperiodically rotated overlapping parallel lines with enhanced reconstructionSENSEsensitivity encodingSNRsignal-to-noise ratioSS-EPIsingle-shot echo-planar imagingTSEturbo spin-echo ER -