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The value of non echo planar, diffusion-weighted magnetic resonance imaging for the detection of residual or recurrent middle-ear cholesteatoma

Published online by Cambridge University Press:  08 July 2014

S Velthuis ,
K J van Everdingen ,
J J Quak  and
D R Colnot
S Velthuis
Affiliation:
Department of Radiology, Diakonessenhuis Utrecht, The Netherlands
K J van Everdingen
Affiliation:
Department of Radiology, Diakonessenhuis Utrecht, The Netherlands
J J Quak
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Diakonessenhuis Utrecht, The Netherlands
D R Colnot*
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Diakonessenhuis Utrecht, The Netherlands
*
Address for correspondence:Dr David R Colnot, Department of Otolaryngology/Head and Neck Surgery, Diakonessenhuis Utrecht, PO Box 80250, 3508 TJ Utrecht, The Netherlands Fax: +31 88 250 6738 E-mail: dcolnot@diakhuis.nl
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Abstract

Objective:

To determine the value of non echo planar, diffusion-weighted magnetic resonance imaging for detection of residual and recurrent middle-ear cholesteatoma after combined-approach tympanoplasty.

Method:

The magnetic resonance imaging findings after primary surgery for cholesteatoma were compared with intra-operative findings at ‘second-look’ surgery or with clinical follow-up findings.

Results:

Forty-eight magnetic resonance imaging studies were performed in 38 patients. Second-look surgery was performed 21 times in 18 patients. The remaining patients were followed up at the out-patient clinic. There were no false-positive findings with non echo planar, diffusion-weighted magnetic resonance imaging; however, there were four false-negative findings. The mean maximum diameter of recurrent cholesteatoma, as assessed using magnetic resonance imaging, was 11.7 mm (range, 4.4–25.3 mm). The sensitivity of non echo planar, diffusion-weighted magnetic resonance imaging for detecting cholesteatoma prior to second-look surgery was 0.76, with a specificity of 1.00. When clinical follow up of the non-operated ears was included in the analysis, sensitivity was 0.81 and specificity was 1.00.

Conclusion:

Recurrent cholesteatoma can be accurately detected using non echo planar, diffusion-weighted magnetic resonance imaging. Our study, however, also showed some false-negative results. Therefore, strict out-patient follow up is mandatory for those considering using this technique instead of standard second-look surgery.

Keywords

CholesteatomaMagnetic Resonance ImagingDiffusion Magnetic Resonance ImagingEcho-Planar ImagingFollow-Up Studies
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 7 , July 2014 , pp. 599 - 603
Copyright
Copyright © JLO (1984) Limited 2014 

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