Hostname: page-component-848d4c4894-ndmmz Total loading time: 0 Render date: 2024-05-07T06:05:03.762Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  22 January 2018

R Nash ,
R K Lingam ,
D Chandrasekharan  and
A Singh
R Nash*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Northwick Park Hospital, Harrow, UK
R K Lingam
Affiliation:
Department of Radiology, Northwick Park Hospital, Harrow, UK
D Chandrasekharan
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Northwick Park Hospital, Harrow, UK
A Singh
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Northwick Park Hospital, Harrow, UK
*
Address for correspondence: Mr Robert Nash, Department of Otolaryngology, Head and Neck Surgery, Northwick Park Hospital, Harrow HA1 3UJ, UK E-mail: mr.robert.nash@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

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.

Keywords

CholesteatomaDiffusion Weighted MRITympanic MembraneOtitis Media
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 3 , March 2018 , pp. 207 - 213
Copyright
Copyright © JLO (1984) Limited 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Jindal, M, Riskalla, A, Jiang, D, Connor, S, O'Connor, AF. A systematic review of diffusion-weighted magnetic resonance imaging in the assessment of postoperative cholesteatoma. Otol Neurotol 2011;32:1243–9Google Scholar
2 De Foer, B, Vercruysse, JP, Bernaerts, A, Deckers, F, Pouillon, M, Somers, T et al. Detection of postoperative residual cholesteatoma with non-echo-planar diffusion-weighted magnetic resonance imaging. Otol Neurotol 2008;29:513–17Google Scholar
3 Huins, CT, Singh, A, Lingam, RK, Kalan, A. Detecting cholesteatoma with nonecho planar (HASTE) diffusion-weighted magnetic resonance imaging. Otolaryngol Head Neck Surg 2010;143:141–6Google Scholar
4 Dubrulle, F, Souillard, R, Chechin, D, Vaneecloo, FM, Desaulty, A, Vincent, C. Diffusion-weighted MR imaging sequence in the detection of postoperative recurrent cholesteatoma. Radiology 2006;238:604–10Google Scholar
5 Pizzini, FB, Barbieri, F, Beltramello, A, Alessandrini, F, Fiorino, F. HASTE diffusion-weighted 3-Tesla magnetic resonance imaging in the diagnosis of primary and relapsing cholesteatoma. Otol Neurotol 2010;31:596–602 Google Scholar
6 Akkari, M, Gabrillargues, J, Saroul, N, Pereira, B, Russier, M, Mom, T et al. Contribution of magnetic resonance imaging to the diagnosis of middle ear cholesteatoma: analysis of a series of 97 cases. Eur Ann Otorhinolaryngol Head Neck Dis 2014;131:153–8Google Scholar
7 Ilıca, AT, Hıdır, Y, Bulakbaşı, N, Satar, B, Güvenç, I, Arslan, HH et al. HASTE diffusion-weighted MRI for the reliable detection of cholesteatoma. Diagn Interv Radiol 2012;18:153–8Google Scholar
8 Khemani, S, Lingam, RK, Kalan, A, Singh, A. The value of non-echo planar HASTE diffusion-weighted MR imaging in the detection, localisation and prediction of extent of postoperative cholesteatoma. Clin Otolaryngol 2011;36:306–12Google Scholar
9 Majithia, A, Lingam, RK, Nash, R, Khemani, S, Kalan, A, Singh, A. Staging primary middle ear cholesteatoma with non-echoplanar (half-Fourier-acquisition single-shot turbo-spin-echo) diffusion-weighted magnetic resonance imaging helps plan surgery in 22 patients: our experience. Clin Otolaryngol 2012;37:325–30Google Scholar
10 Migirov, L, Wolf, M, Greenberg, G, Eyal, A. Non-EPI DW MRI in planning the surgical approach to primary and recurrent cholesteatoma. Otol Neurotol 2014;35:121–5Google Scholar
11 Alvo, A, Garrido, C, Salas, Á, Miranda, G, Stott, CE, Delano, PH. Use of non-echo-planar diffusion-weighted MR imaging for the detection of cholesteatomas in high-risk tympanic retraction pockets. AJNR Am J Neuroradiol 2014;35:1820–4Google Scholar
12 Khemani, S, Singh, A, Lingam, RK, Kalan, A. Imaging of postoperative middle ear cholesteatoma. Clin Radiol 2011;66:760–7Google Scholar
13 Plouin-Gaudon, I, Bossard, D, Ayari-Khalfallah, S, Froehlich, P. Fusion of MRIs and CT scans for surgical treatment of cholesteatoma of the middle ear in children. Arch Otolaryngol Head Neck Surg 2010;136:878–83CrossRefGoogle ScholarPubMed