title: The value of single-shot turbo spin-echo diffusion-weighted MR imaging in the detection of middle ear cholesteatoma.
abstract: BACKGROUND
  Single-shot (SS) turbo spin-echo (TSE) diffusion-weighted (DW) magnetic resonance imaging (MRI) is a non echo-planar imaging (EPI) technique recently reported for the evaluation of middle ear cholesteatoma. We prospectively evaluated a SS TSE DW sequence in detecting congenital or acquired middle ear cholesteatoma and evaluated the size of middle ear cholesteatoma detectable with this sequence. The aim of this study was not to differentiate between inflammatory tissue and cholesteatoma using SS TSE DW imaging.
  
  
  METHODS
  A group of 21 patients strongly suspected clinically and/or otoscopically of having a middle ear cholesteatoma without any history of prior surgery were evaluated with late post-gadolinium MRI including this SS TSE DW sequence.
  
  
  RESULTS
  A total of 21 middle ear cholesteatomas (5 congenital and 16 acquired) were found at surgery with a size varying between 2 and 19 mm. Hyperintense signal on SS TSE DW imaging compatible with cholesteatoma was found in 19 patients. One patient showed no hyperintensity due to autoevacuation of the cholesteatoma sac into the external auditory canal. Another patient showed no hyperintensity because of motion artifacts.
  
  
  CONCLUSIONS
  This study shows the high sensitivity of this SS TSE DW sequence in detecting small middle ear cholesteatomas, with a size limit as small as 2 mm.
authors.affiliation: Department of Radiology, A.Z. Sint-Augustinus Hospital, Antwerp, Belgium. bert.defoer@GZA.be
authors.forename: Bert
authors.initials: B
authors.lastname: De Foer
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Vercruysse
authors.forename: Anja
authors.initials: A
authors.lastname: Bernaerts
authors.forename: Joachim
authors.initials: J
authors.lastname: Maes
authors.forename: Filip
authors.initials: F
authors.lastname: Deckers
authors.forename: Johan
authors.initials: J
authors.lastname: Michiels
authors.forename: Thomas
authors.initials: T
authors.lastname: Somers
authors.forename: Marc
authors.initials: M
authors.lastname: Pouillon
authors.forename: Erwin
authors.initials: E
authors.lastname: Offeciers
authors.forename: Jan W
authors.initials: JW
authors.lastname: Casselman
mesh_terms: D000328:Adult; D016477:Artifacts; D018424:Cholesteatoma, Middle Ear / Q000151:congenital / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D004424:Ear Canal / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012422:Rupture, Spontaneous; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed