RT Journal Article SR Electronic 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. FD American Society of Neuroradiology SP 1915 OP 1918 DO 10.3174/ajnr.A2651 VO 32 IS 10 A1 K. Yamashita A1 T. Yoshiura A1 A. Hiwatashi A1 H. Kamano A1 T. Dashjamts A1 S. Shibata A1 A. Tamae A1 H. Honda YR 2011 UL http://www.ajnr.org/content/32/10/1915.abstract AB 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