The value of turbo spin-echo diffusion-weighted imaging apparent diffusion coefficient in the diagnosis of temporal bone cholesteatoma

Abstract

To explore the value of the applying the apparent diffusion coefficient (ADC) to the quantitative diagnosis of temporal bone cholesteatoma. Seventy-one patients clinically suspected of temporal bone cholesteatoma were enrolled prospectively. These patients underwent ear magnetic resonance imaging (MRI) and turbo spin-echo diffusion-weighted imaging (TSE-DWI) using a Philips Ingenia 3 T superconductive MRI system, and their ADCs were measured. Subsequently, all enrolled patients underwent surgery within 15 days of the MRI. Using receiver operating characteristic (ROC) curve analysis, the optimal threshold and diagnostic performance for diagnosing temporal bone cholesteatoma were determined. Logistic regression modelling was used to combine ADCs and T1-weighted imaging (T1WI) sequences and calculate the combined diagnostic performance. Based on the pathology results, patients were categorised into the cholesteatoma group (CS group, n=43) and the non-cholesteatoma group (NCS group, n=28). In the CS group, ADCs were significantly lower (mean, 0.87±0.31×10-3 mm2/s) than in the NCS group (mean, 1.87±0.49×10-3 mm2/s; p<0.001); the area under the ROC curve (AUC) was 0.915. Based on the optimal threshold of ADC, ≤1.23×10-3 mm2/s, the diagnostic performance was high; the sensitivity and specificity for diagnosing cholesteatoma were 95.35% and 85.71%, respectively. By combining the ADC and T1WI sequence, AUC increased to 0.953, and the sensitivity and specificity were 90.7% and 96.43%, respectively. ADC quantitative analysis has a high value in the preoperative diagnosis of cholesteatoma, and the combination of ADC and T1WI sequences can improve the diagnostic accuracy and specificity and thereby facilitate clinically effective diagnosis.