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[Value of diffusion-weighted MR imaging in the detection of middle ear cholesteatoma]
Noriaki Nagai1, Tetsuya Tono, Keiji Matsuda
1Department of Otolaryngology-Head and Neck Surgery, Miyazaki University School of Medicine, Miyazaki.
Objective:
This study, was conducted to determine the clinical value of diffusion-weighted MR imaging (DWI) in detecting the presence of cholesteatoma.
Subject And Methods:
Fifty-six patients (21 female and 35 male patients; mean age, 43 years) who underwent middle ear surgery were referred to the radiology department for a preoperative DWI study.
Results:
DWI depicted 41 out of 48 cholesteatomas involving the middle ear cavity (sensitivity, 85.4%). Seven patients with middle ear cholesteatoma who showed negative DWI findings (false-negative cases) had limited keratin accumulation due to simple atelectasis or meticulous evacuation of keratin debris before the MRI study. No falsepositive cases were found in this study (specificity, 100%). The positive predictive value and negative predictive value were 100% and 53.3%, respectively. The minimum size of middle ear cholesteatoma detected by the current MRI system was 5mm.
Conclusion:
Diffusion-weighted MR imaging was useful for the detection of middle ear cholesteatoma.
