The value of single-shot turbo spin-echo diffusion-weighted MR imaging in the detection of middle ear cholesteatoma.
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.
De Foer
Bert
B
Department of Radiology, A.Z. Sint-Augustinus Hospital, Antwerp, Belgium. bert.defoer@GZA.be
Vercruysse
Jean-Philippe
JP
Bernaerts
Anja
A
Maes
Joachim
J
Deckers
Filip
F
Michiels
Johan
J
Somers
Thomas
T
Pouillon
Marc
M
Offeciers
Erwin
E
Casselman
Jan W
JW
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