Abstract
Previous reports have shown that DWI is useful in detecting cholesteatoma. SS-EPI is the most widely used DWI technique. However, SS-EPI may have susceptibility artifacts due to field inhomogeneity in the imaging of the temporal bone region. Our purpose was to prospectively evaluate the advantage of MS-EPI for the diagnosis of middle ear cholesteatoma by comparing it with SS-EPI. We studied 29 patients with preoperatively suspected acquired cholesteatoma. Each patient underwent an MR imaging examination including both SS-EPI and MS-EPI by using a 1.5T MR imaging scanner. Images of the 29 patients (58 temporal bones including 30 with and 28 without cholesteatoma) were reviewed by 2 independent neuroradiologists. The confidence level for the presence of cholesteatoma was graded on a scale of 0-2 (0 = none, 1 = equivocal, 2 = definite). Interobserver agreement as well as sensitivity, specificity, and accuracy were assessed for the 2 readers. Excellent interobserver agreement was shown for both MS-EPI (κ = 0.856) and SS-EPI (κ = 0.820). MS-EPI was associated with higher sensitivity (76.7%) and accuracy (87.9%) than SS-EPI (sensitivity = 50.0%, accuracy = 74.1%) (P < .05), while both methods showed 100% specificity. Compared with SS-EPI, MS-EPI improves the accuracy of the diagnosis of acquired middle ear cholesteatomas.
Highlights
MethodsWe studied 29 patients with preoperatively suspected acquired cholesteatoma. Each patient underwent an MR imaging examination including both SS-EPI and MS-EPI by using a 1.5T MR imaging scanner
AND PURPOSE: Previous reports have shown that DWI is useful in detecting cholesteatoma
MS-EPI was associated with higher sensitivity (76.7%) and accuracy (87.9%) than SS-EPI (P Ͻ .05), while both methods showed 100% specificity
Summary
We studied 29 patients with preoperatively suspected acquired cholesteatoma. Each patient underwent an MR imaging examination including both SS-EPI and MS-EPI by using a 1.5T MR imaging scanner. Written informed consent was obtained from all patients These patients underwent MR imaging between July 2009 and August 2010. We prospectively studied 29 consecutive patients (13 men and 16 women; age range, 18 – 81 years of age; mean, 49.4 Ϯ 17.2 years) who planned to undergo surgery. One of these patients was suspected of having bilateral primary cholesteatoma, while unilateral disease was suspected in the other 28 patients (18 primary and 10 recurrent). These patients underwent preoperative MR imaging on the day before surgery. Final diagnosis was surgically determined by 2 otorhinolaryngologists, with 12 and 11 years of experience
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