Cholesteatoma and coexisting findings diagnosed incidentally on MRI.
The explosive growth in the use of diffusion-weighted magnetic resonance imaging (MRI) in the pre- and postoperative evaluations of patients with cholesteatoma has led to a concomitant increase in the number of incidental findings in this population. We describe our retrospective examination of MRI studies in cholesteatoma patients to look for the presence of other coexisting abnormalities. We examined the brain MRIs of 103 patients-45 males and 58 females, aged 3 to 81 years (mean: 31.9 ± 21.3)-who had undergone pre- or postoperative imaging during the management of a cholesteatoma. The MRIs revealed the presence of at least one other anomaly in 79 of these patients (76.7%)-36 males and 43 females, aged 3 to 81 years (mean: 43.5 ± 18.2). These 79 MRIs detected a total of 124 lesions that had been coexisting with cholesteatomas; some of these lesions had overlapped with the cholesteatoma. The two most common findings were sinonasal mucoperiosteal thickening and polyposis (n = 66) and white-matter changes (n = 29). Our results establish the need for routine skilled interpretation of brain MRIs by expert neuroradiologists to ensure that findings coexisting with cholesteatoma are detected so that appropriate management can be provided.
Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, 5262l, Israel.
Gahl
G
Greenberg
Ana
A
Eyal
Arkadi
A
Yakirevitch
Michael
M
Wolf
Lela
L
Migirov
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D015897:Comorbidity; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D033162:Incidental Findings; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000453:epidemiology; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000000981:diagnostic imaging* / Q000453:epidemiology; D009668:Nose Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D010900:Pituitary Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult