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MR imaging features of acute mastoiditis and their clinical relevance

R Saat1, A H Laulajainen-Hongisto2, G Mahmood3

  • 1From the Department of Radiology, HUS Medical Imaging Center (R.S., G.M., A.T.M.) Department of Radiology (R.S.), East Tallinn Central Hospital, Tallinn, Estonia. riste.saat@hus.fi.

AJNR. American Journal of Neuroradiology
|October 18, 2014
PubMed
Abstract

Insights

Acute mastoiditis causes significant intra- and extratemporal changes on MR imaging, with children experiencing more severe complications like opacification and enhancement. This study details these findings for better diagnosis.

Area of Science:

  • Radiology
  • Otolaryngology
  • Pediatric Imaging

Background:

  • Acute mastoiditis diagnosis often relies on MR imaging for intracranial complications.
  • The intratemporal manifestations of acute mastoiditis on MR imaging have been less emphasized.
  • Understanding these features is crucial for comprehensive diagnosis and management.

Purpose of the Study:

  • To evaluate the specific MR imaging features of acute mastoiditis within the temporal bone.
  • To correlate these imaging findings with clinical relevance and patient outcomes.
  • To compare imaging findings between adult and pediatric patients.

Main Methods:

  • Retrospective analysis of MR imaging and medical records from 31 acute mastoiditis patients (21 adults, 10 children).
  • Assessment of temporal bone opacification, signal characteristics, enhancement patterns, bone destruction, and complications.
  • Correlation of findings with clinical data and comparison between pediatric and adult cohorts.

Main Results:

  • Opacification of the tympanic cavity and mastoid air cells was common, especially in children (80-90%).
  • Intramastoid signal changes and enhancement, including dural enhancement, were observed.
  • Complications included intratemporal abscess (23%), subperiosteal abscess (19%), and labyrinth involvement (16%), with higher prevalence in children.

Conclusions:

  • Acute mastoiditis presents with diverse intra- and extratemporal MR imaging findings.
  • Children exhibit a higher incidence of severe manifestations, including total opacification, intense enhancement, bone erosion, and extracranial complications.
  • MR imaging is vital for characterizing the full spectrum of acute mastoiditis and its complications.

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