The Diagnostic Accuracy of Non-Echo-Planar Diffusion-Weighted Imaging in the Detection of Residual and/or Recurrent Cholesteatoma of the Temporal Bone

Abstract

BACKGROUND AND PURPOSE:Non-EPI DWI is a promising alternative to second-look surgery for the detection of residual and/or recurrent cholesteatoma. We evaluated the diagnostic accuracy, expressed as a positive predictive value, of MR imaging for the detection of residual and/or recurrent cholesteatoma in our hospital.

Accuracy of turbo spin-echo diffusion-weighted imaging signal intensity measurements for the diagnosis of cholesteatoma

“…Although the qualitative non-echoplanar methods have high diagnostic accuracy (as seen above), there are still instances where the high signal of diffusion-weighted images does not unequivocally represent CS. The false positive cases reported in the literature include cholesterol granuloma, abscess, inserted fat graft, bony cement as well as chronic inflammatory tissue (7,(10)(11)(12)(13)(14)30). The cholesterol granuloma can be differentiated by its T1 hyperintensity, while the abscess can be differentiated by its acute clinical presentation as well as its very low ADC value (10,12,18).…”

Detection of cholesteatoma: High-resolution DWI using RS-EPI and parallel imaging at 3 tesla

“…Although many techniques (e.g. spin-echo based sequences or PROPELLER technique) were experimented for diminishing these artefacts, there are several limitations for each technique such as low resolution or long imaging time [2,[4][5][6][7]9,10].…”

“…Geometric distortion may lead to false negative or positive results by preventing the optimal evaluation of middle ear cavity and those artefacts are more prominent at 3 tesla (T) devices [2,8]. New techniques have been developed to avoid these artefacts including multi-shot echo-planar imaging (EPI), non-EPI or periodically rotated overlapping parallel lines with enhancedreconstruction (PROPELLER) techniques [2,7,9,10].…”

Detectability and anatomical correlation of middle ear cholesteatoma using fused thin slice non-echo planar imaging diffusion-weighted image and magnetic resonance cisternography (FTS-nEPID)

“…Non EPI DWI is useful as a method that does not involve gadolinium contrast media. These methods can also be employed to detect postoperative residual and/or recurrent cholesteatomas [15][16][17][18][19][20]. We performed thinner slice non EPI DWIs, with 1 mm slice thickness, in order to detect smaller cholesteatomas in this study.…”