title: The accuracy and sensitivity of diffusion-weighted magnetic resonance imaging with Apparent Diffusion Coefficients in diagnosis of recurrent cholesteatoma.
abstract: OBJECTIVE
  To evaluate the accuracy and sensitivity of diffusion-weighted magnetic resonance imaging with ADC value combined with MDCT in evaluating recurrent cholesteatoma.
  
  
  METHODS
  Thirty patients (20 females and 10 males), their age ranged from 10 to 40years, had undergone a tympanomastoid surgery for a cholesteatoma of the middle ear underwent MDCT and MR DWI examination before second- or third-look surgery from May 2015 to October 2016.
  
  
  RESULTS
  CT showed partial opacification of the tympanomastoid cavity in 10 ears and complete opacification in 21 ears. CT detects 10 cases out of 20 cases of recurrent cholesteatoma with sensitivity 47.6%, specificity 100%, and NPP 47.6%. DWI depicted 21 out of 20 cases proved cholesteatoma patients (sensitivity 100%, specificity 90%, PPV 95.2% and P value is 0.001). All MRI of patients without cholesteatoma were correctly interpreted as showing negative findings for cholesteatoma (specificity = 100%). The ADC of cholesteatoma group (21 ears) were ranged from 553 to 759 × 10-3mm2/s and the ADCs of non cholesteatoma group (10 ears) was ranged from 1495.8 to 1766.8 × 10-3mm2/s. Cut off value of cholesteatoma is ≤759 × 10-3mm2/s.
  
  
  CONCLUSIONS
  MR DWI with ADC combined with MDCT has high sensitivity, specificity, accuracy in detecting recurrent cholesteatoma.
authors.affiliation: Department of Radiology, Minia University Hospital, Minia, Egypt.
authors.forename: Nasr Mohamed M
authors.initials: NM
authors.lastname: Osman
authors.affiliation: Department of Otolaryngology, Minia University Hospital, Minia, Egypt.
authors.forename: Ahmed Abdel
authors.initials: AA
authors.lastname: Rahman
authors.affiliation: Department of Otolaryngology, Minia University Hospital, Minia, Egypt.
authors.forename: Moustafa Talaat Abdel Hakim
authors.initials: MT
authors.lastname: Ali
keywords: Apparent diffusion coefficient; Magnetic Resonance Diffusion weighted imaging; Multidetector computed tomography; Recurrent cholesteatoma