title: Does Diffusion-Weighted MR Imaging Change the Follow-Up Strategy in Cases with Residual Cholesteatoma?
abstract: OBJECTIVE
  To analyze the effectiveness of diffusion-weighted magnetic resonance imaging (DW-MRI) in the evaluation of recurrent cholesteatomas.
  
  
  METHODS
  Twenty-three patients undergoing second-look surgery were included in our study. There were 14 men and 9 women with ages ranging from 10 to 50. All patients underwent DW-MRI prior to second-look surgery. All magnetic resonance imaging (MRI) examinations were performed with a 1.5-T MRI unit using a standard 8-channel neurovascular coil. DW-MRI and apparent diffusion coefficient maps were included in the examination. Cholesteatoma was diagnosed on the DW-MRI as a marked hyperintense signal in comparison with brain tissue. All cases were classified as positive or negative.
  
  
  RESULTS
  The sensitivity and specificity of DW-MRI were 86% and 87%, respectively. The positive predictive value of DW-MRI was 92%, while the negative predictive value was 77%.
  
  
  CONCLUSIONS
  The DW-MRI technique is an important and effective technique in the evaluation of residual cholesteatoma. It can be an alternative method to second-look surgery, which can spare patients repeat operations.
authors.affiliation: Department of Otolaryngology, Ministry of Health, Rize Çayeli State Hospital, Rize, Turkey. ysfdndr@gmail.com.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Dündar
authors.forename: Fatih Alper
authors.initials: FA
authors.lastname: Akcan
authors.forename: Alper
authors.initials: A
authors.lastname: Dilli
authors.forename: Emel
authors.initials: E
authors.lastname: Tatar
authors.forename: Hakan
authors.initials: H
authors.lastname: Korkmaz
authors.forename: Ali
authors.initials: A
authors.lastname: Özdek
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000175:diagnosis* / Q000601:surgery; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D024162:Second-Look Surgery / Q000379:methods*; D055815:Young Adult