Magnetic resonance imaging in acute mastoiditis.
BACKGROUND
In cases of suspected mastoiditis, imaging is used to evaluate the extent of mastoid destruction and possible complications. The role of magnetic resonance imaging (MRI) in mastoiditis has not been systematically evaluated.


OBJECTIVE
To assess the diagnostic performance of MRI in patients with suspected acute mastoiditis.


METHODS
Twenty-three patients with suspected acute mastoiditis were included in this retrospective study (15 boys, 8 girls; mean age, 2 years 11 months). All patients were examined on a 1.5 T MRI system. The MRI examination included both enhanced and non-enhanced turbo spin echo (TSE), diffusion-weighted images, and venous time-of-flight magnetic resonance angiography (TOF MRA) for the evaluation of the venous sinuses. Surgical findings, as well as clinical and imaging follow-up were used as the standard of reference. The sensitivity and accuracy of MRI for mastoiditis and subperiosteal abscesses was calculated.


RESULTS
Twenty (87%) of 23 patients had mastoiditis, and 12 (52%) of 23 patients had a subperiosteal abscess in addition to mastoiditis. Mastoiditis and subperiosteal abscesses were identified by MRI in all cases. Sensitivity for mastoiditis was 100%, specificity was 66%, and accuracy was 86%. Sensitivity for subperiosteal abscesses was 100% and accuracy was 100%.


CONCLUSIONS
Multiparametric MRI has high accuracy for mastoiditis and subperiosteal abscesses.
Department of Radiology, Dresden University Hospital, Dresden, Germany.
Ivan
I
Platzek
Department of Neuroradiology, Dresden University Hospital, Dresden, Germany.
Hagen H
HH
Kitzler
Department of Otolaryngology, Dresden University Hospital, Dresden, Germany.
Volker
V
Gudziol
Department of Radiology, Dresden University Hospital, Dresden, Germany.
Michael
M
Laniado
Department of Radiology, Dresden University Hospital, Dresden, Germany.
Gabriele
G
Hahn
Mastoiditis; children; infection; magnetic resonance imaging (MRI)