Does Diffusion-Weighted MR Imaging Change the Follow-Up Strategy in Cases with Residual Cholesteatoma?

• Published in: The journal of international advanced otology Vol. 11; no. 1; pp. 58 - 62
• Main Authors: Dündar, Yusuf, Akcan, Fatih Alper, Dilli, Alper, Tatar, Emel, Korkmaz, Hakan, Özdek, Ali
• Format: Journal Article
• Language: English
• Published: Turkey 01.04.2015
• Subjects: Adolescent; Adult; Child; Cholesteatoma, Middle Ear - diagnosis; Cholesteatoma, Middle Ear - surgery; Diffusion Magnetic Resonance Imaging - methods; Female; Follow-Up Studies; Humans; Male; Middle Aged; Otologic Surgical Procedures - methods; Prospective Studies; Reproducibility of Results; Second-Look Surgery - methods; Young Adult
• ISSN: 1308-7649; 2148-3817
• DOI: 10.5152/iao.2014.216

To analyze the effectiveness of diffusion-weighted magnetic resonance imaging (DW-MRI) in the evaluation of recurrent cholesteatomas. 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. 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%. 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.