title: [Importance of diffusion weighted magnetic resonance imaging at differentiation of cholesteatoma and granulation tissue in patients with chronic suppurative otitis media].
abstract: OBJECTIVE
  This study aims to report the significance of echo-planar diffusion-weighted imaging (EP-DWI) in preoperative magnetic resonance imaging of patients with surgically corrected cholesteatoma and granulation tissue according to DWI and apparent diffusion coefficient (ADC) values.
  
  
  METHODS
  Ninety-one patients (52 males, 39 females; mean age 40.7±15.8 years; range 3 to 77 years) who admitted to radiology clinic of our hospital between December 2009 and May 2011 with a pre-diagnosis of chronic otitis media with primary acquired cholesteatoma and assessed preoperatively in our clinic by ear magnetic resonance imaging and DWI were included in the study. Diffusion-weighted imaging results were compared with operative findings and pathology results. Patients were retrospectively evaluated using picture archiving and communication system. Diffusion-weighted imaging and ADC images were examined qualitatively and quantitatively.
  
  
  RESULTS
  Ninety-one patients suspected of cholesteatoma were operated. According to the results of operations, 50 patients had cholesteatoma and 41 patients had granulation tissue. The mean DWI values of patients with cholesteatoma were significantly higher than patients with granulation tissue (p<0.05). The mean ADC values of patients with cholesteatoma were significantly lower than patients with granulation tissue (p<0.05). The sensitivity and specificity of EP-DWI in detection of cholesteatoma were 97.6% and 92.0%, respectively.
  
  
  CONCLUSIONS
  Echo-planar diffusion-weighted imaging by using ADC and DWI is a valuable tool with high sensitivity and specificity rates in detecting cholesteatoma particularly bigger than 5 mm and in differentiating them from other pathologies.
authors.affiliation: Department of Radiology, Malatya State Hospital, 44090 Malatya, Turkey. tuzcugoksel@yahoo.com.
authors.forename: Göksel
authors.initials: G
authors.lastname: Tuzcu
authors.forename: Aytül Hande
authors.initials: AH
authors.lastname: Yardımcı
authors.forename: Önder
authors.initials: Ö
authors.lastname: Turna
authors.forename: Reyyan Elif
authors.initials: RE
authors.lastname: Göner
authors.forename: Engin
authors.initials: E
authors.lastname: Acıoğlu
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000175:diagnosis* / Q000601:surgery; D002908:Chronic Disease; D038524:Diffusion Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D017352:Echo-Planar Imaging / Q000706:statistics & numerical data*; D005260:Female; D006097:Granulation Tissue / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000175:diagnosis; D011873:Radiology Information Systems; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult