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Diffusion-weighted magnetic resonance imaging for residual and recurrent cholesteatoma: a systematic review and

J Muzaffar1, C Metcalfe1, S Colley1

  • 1Queen Elizabeth Hospital Birmingham, Birmingham, UK.

Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
|October 5, 2016
PubMed
Abstract

Insights

Diffusion-weighted MRI effectively diagnoses recurrent cholesteatoma after ear surgery. Newer non-echoplanar imaging (non-EPI) sequences show superior sensitivity and specificity compared to older echoplanar imaging (EPI) techniques.

Area of Science:

  • Otolaryngology
  • Radiology
  • Medical Imaging

Background:

  • Recurrent or residual cholesteatoma diagnosis and management pose challenges.
  • Diffusion-weighted imaging magnetic resonance imaging (MRI) is utilized for follow-up.
  • Non-echoplanar imaging (non-EPI) sequences are emerging as potentially superior to older echoplanar imaging (EPI) sequences.

Purpose of the Study:

  • To evaluate the diagnostic utility of diffusion-weighted MRI for recurrent or residual cholesteatoma.
  • To compare the effectiveness of different MRI sequences in detecting cholesteatoma recurrence.

Main Methods:

  • A systematic review and meta-analysis was conducted.
  • Searches were performed across multiple databases (MEDLINE, EMBASE, CINAHL, Web of Science, Cochrane Database) without date or language restrictions.
  • Studies included adults and children with confirmed recurrent/residual cholesteatoma post-tympanomastoid surgery.

Main Results:

  • 27 studies comprising 727 patient episodes met the inclusion criteria.
  • EPI sequences demonstrated sensitivity of 71.82% and specificity of 89.36%.
  • Non-EPI sequences showed improved sensitivity (89.79%) and specificity (94.57%), with the sensitivity improvement being statistically significant (P=0.02).

Conclusions:

  • Diffusion-weighted MRI is a sensitive and specific tool for detecting cholesteatoma recurrence or residuals post-surgery.
  • Non-EPI diffusion-weighted MRI techniques offer superior diagnostic performance compared to EPI techniques.

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