Purpose:To retrospectively compare non-echo-planar (non-EP) diffusion-weighted (DW) imaging, delayed gadoliniumenhanced T1-weighted magnetic resonance (MR) imaging, and the combination of both techniques in the evaluation of patients with cholesteatoma. Materials and Methods:This institutional review board-approved study, for which the need to obtain informed consent was waived, included 57 patients clinically suspected of having a middle ear cholesteatoma without a history of surgery and 63 patients imaged before "second-look" surgery. Four blinded radiologists evaluated three sets of MR images: a set of delayed gadolinium-enhanced T1-weighted images, a set of non-EP DW images, and a set of both kinds of images. Overall sensitivity, specifi city, negative predictive value (NPV), and positive predictive value (PPV), as well as intra-and interobserver agreement, were assessed and compared among methods. To correct for the correlation between different readings, a generalized estimating equations logistic regression model was fi tted. Results were compared with surgical results, which were regarded as the standard of reference. Results:Sensitivity, specifi city, NPV, and PPV were signifi cantly different between the three methods ( P , .005). Sensitivity and specifi city, respectively, were 56.7% and 67.6% with the delayed gadolinium-enhanced T1-weighted images and 82.6% and 87.2% with the non-EP DW images. Sensitivity for the combination of both kinds of images was 84.2%, while specifi city was 88.2%. The overall PPV was 88.0% for delayed gadolinium-enhanced T1-weighted images, 96.0% for non-EP DW images, and 96.3%for the combination of both kinds of images. The overall NPV was 27.0% for delayed gadolinium-enhanced T1-weighted images, 56.5% for non-EP DW images, and 59.6% for the combination of both kinds of images. Conclusion:MR imaging for detection of middle ear cholesteatoma can be performed by using non-EP DW imaging sequences alone. Use of the non-EP DW imaging sequence combined with a delayed gadolinium-enhanced T1-weighted sequence yielded no signifi cant increases in sensitivity, specifi city, NPV, or PPV over the use of the non-EP DW imaging sequence alone.q RSNA, 2010 Supplemental material: http://radiology.rsna.org/lookup /suppl

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The crazy-paving pattern is a linear pattern superimposed on a background of ground-glass opacity, resembling irregularly shaped paving stones. The crazy-paving pattern is initially described as the pathognomonic sign of alveolar proteinosis. Nowadays this pattern is a common finding on high-resolution CT imaging, and can be seen in a number of acute and chronic diseases. The purpose of this paper is to illustrate different diseases that cause this crazy-paving pattern and to correlate the radiological findings from computed tomography with the histopathological findings.

Objective To determine the pattern of apparent diffusion coefficient (ADC) values in the normal fetal brain obtained with diffusion-weighted images (DWI) on magnetic resonance imaging (MRI) as a template for normal brain development throughout gestation. Methods

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