Mastoiditis on MRI: fact or artifact?
Fluid signal in the mastoid can be an incidental finding on T2-weighted magnetic resonance imaging and often is interpreted as mastoiditis by radiologists. This study examines 28 consecutive cases of such erroneously diagnosed "mastoiditis" and documents the presence or absence of otologic symptoms and clinical signs. We found a very low prevalence of otologic symptoms or pathology and no cases of mastoiditis in these patients, and we determined that magnetic resonance imaging is not an effective screening modality for mastoiditis. We also reviewed the literature on current diagnostic criteria for mastoiditis and propose alternative terminology to replace the use of excessively alarming terms such as "mastoiditis" unless they apply to that specific clinical diagnosis.
Meredith
James R
JR
Division of Otology/Neurotology, Department of Otolaryngology-Head and Neck Surgery, University of South Florida College of Medicine, Tampa, FL 33612, USA.
Boyev
K Paul
KP
D000046:Academic Medical Centers; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D015331:Cohort Studies; D017046:Cost Savings; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging / Q000191:economics / Q000379:methods*; D008297:Male; D008417:Mastoiditis / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D010808:Physical Examination / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000379:methods*; D019564:Unnecessary Procedures; D055815:Young Adult