HASTE diffusion-weighted 3-Tesla magnetic resonance imaging in the diagnosis of primary and relapsing cholesteatoma.
OBJECTIVE
To evaluate the value of half-Fourier acquisition single-shot turbo-spin-echo diffusion-weighted magnetic resonance imaging (HASTE DW MRI) using a 3-Tesla (3T) unit in the diagnosis of primary and relapsing cholesteatoma.


METHODS
Retrospective observational investigation.


METHODS
Tertiary referral center.


METHODS
Seventeen patients suspected of having a primary cholesteatoma without clear clinical evidence of the lesion, and 13 patients who were candidates to a second-stage tympanoplasty to rule out a relapsing cholesteatoma or reconstruct the ossicular chain were investigated.


METHODS
All patients were scanned in a 3T scanner with a 4-channel head coil using T2 HASTE DW MRI technique sequences in axial and coronal planes covering the middle ear and mastoid regions.


METHODS
Images were considered positive for cholesteatoma in the presence of a hyperintense, patchy-like lesion in the petrous bone.


RESULTS
Images showed a high signal intensity suggestive of primary cholesteatoma in 10 of 17 patients and of relapsing cholesteatoma in 7 of 13 patients. Of the 17 subjects, 15 with positive MRI findings were operated on, and the presence of cholesteatoma (ranging from 2 to 20 mm in size) was confirmed at surgery. Of the 13 subjects shown to be negative on HASTE DW MRI for cholesteatoma, 11 were operated on and were all confirmed to be cholesteatoma-free.


CONCLUSIONS
Half-Fourier acquisition single-shot turbo-spin-echo diffusion-weighted magnetic resonance imaging technique, using a 3T unit, may be a diagnostic tool for a rapid and highly reliable discrimination between cholesteatomatous and noncholesteatomatous tissue in the middle ear, with 100% of positive and negative predictive values.
Pizzini
Francesca B
FB
Department of Neuroradiology, Ospedale Civile Maggiore, Verona, Italy.
Barbieri
Franco
F
Beltramello
Alberto
A
Alessandrini
Franco
F
Fiorino
Francesco
F
D000328:Adult; D000368:Aged; D018424:Cholesteatoma, Middle Ear / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity