RT Journal Article
SR Electronic
T1 Readout-Segmented Echo-Planar DWI for the Detection of Cholesteatomas: Correlation with Surgical Validation
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1055
OP 1059
DO 10.3174/ajnr.A6079
VO 40
IS 6
A1 N. Fischer
A1 V.H. Schartinger
A1 D. Dejaco
A1 J. Schmutzhard
A1 H. Riechelmann
A1 M. Plaikner
A1 B. Henninger
YR 2019
UL http://www.ajnr.org/content/40/6/1055.abstract
AB BACKGROUND AND PURPOSE: MR imaging has become an important tool for the detection of cholesteatomas of the middle ear. Various diffusion-weighted imaging sequences are available and have shown promising results. This study aimed to evaluate readout-segmented echo-planar DWI for the detection of cholesteatoma and compare the results with surgical validation.MATERIALS AND METHODS: Fifty patients with chronic otitis media (24 females and 26 males; range, 12–76 years of age; mean age, 41 years) who underwent MR imaging before an operation of the middle ear (1–169 days) were included. The MR imaging protocol consisted of axial and coronal readout-segmented echo-planar DWI with b-values of 0 and 1000 s/mm2 and 3-mm slice thickness. The readout-segmented echo-planar diffusion-weighted images were fused with standard T2-weighted sequences for better anatomic assignment. The results of the MR imaging evaluation were correlated with the results from the operation.RESULTs: Readout-segmented echo-planar DWI detected 22 of the 25 cases of surgically proved cholesteatoma. It has an accuracy of 92% (95% confidence interval, 80.8%–97.8%), a sensitivity of 88%, a specificity of 96%, a positive predictive value of 96%, and a negative predictive value of 89%. In 1 case, a positive finding for cholesteatoma with readout-segmented echo-planar DWI could not be proved by histology, and in 3 cases, histology yielded a cholesteatoma that was not detected with MR imaging.CONCLUSIONS: Readout-segmented echo-planar DWI is a promising and reliable MR imaging sequence for the detection and exclusion of cholesteatoma.RESOLVEreadout-segmented echo-planar