Value of high-resolution computed tomography and magnetic resonance imaging in the detection of residual cholesteatomas in primary bony obliterated mastoids

Foer, Bert De; Vercruysse, Jean‐Philippe; Pouillon, Marc; Somers, Thomas; Casselman, Jan; Offeciers, Erwin

doi:10.1016/j.amjoto.2006.09.010

Cited by 44 publications

(44 citation statements)

References 13 publications

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“…Lesions of Ͼ5 mm have been reliably detected with the EPI-DWI technique, 14,[21][22][23][24][25][26][27] and even smaller lesions, with non-EPI techniques. 15,[28][29][30][31] In fact, De Foer et al 28 argued that the SS TSE DWI sequence has high enough sensitivity, specificity, and positive and negative predictive values to replace routine second-stage surgery for the detection of residual cholesteatoma.…”

Section: Patient Selectionmentioning

confidence: 90%

“…These EPI images were generally effective for detection of lesions Ն4 or 5 mm, but EPI frequently missed smaller lesions. 14,[21][22][23][24][25][26] This led Vercruysse et al 14 and Venail et al 22 to advocate concurrent use of DWI, considered more specific, and postcontrast T1-weighted images, which were more sensitive.…”

Section: Review Of the Literaturementioning

confidence: 99%

“…14,16,[21][22][23][24][25]27 The EPI-DWI technique was limited by large section thickness, susceptibility artifacts from the skull base, and low resolution. These EPI images were generally effective for detection of lesions Ն4 or 5 mm, but EPI frequently missed smaller lesions.…”

Section: Review Of the Literaturementioning

confidence: 99%

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The Utility of Diffusion-Weighted Imaging for Cholesteatoma Evaluation

Schwartz¹,

Lane²,

Bolster³

et al. 2010

AJNR Am J Neuroradiol

109

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SUMMARY: DWI is a useful technique for the evaluation of cholesteatomas. It can be used to detect them when the physical examination is difficult and CT findings are equivocal, and it is especially useful in the evaluation of recurrent cholesteatoma. Initial DWI techniques only detected larger cholesteatomas, Ͼ5 mm, due to limitations of section thickness and prominent skull base artifacts. Newer techniques allow detection of smaller lesions and may be sufficient to replace second-look surgery in patients with prior cholesteatoma resection.ABBREVIATIONS: ASSET ϭ array spatial sensitivity encoding technique; DWI ϭ diffusion-weighted imaging; EPI ϭ echo-planar imaging; HASTE ϭ half-Fourier acquired single-shot turbo spin-echo; PROPELLER ϭ periodically rotated overlapping parallel lines with enhanced reconstruction; SNR ϭ signal intensity-to-noise ratio; SS TSE ϭ single-shot TSE; TSE ϭ turbo spin-echo C holesteatomas are enlarging collections of keratin within a sac of squamous epithelium and may be congenital or acquired.1 Acquired cholesteatomas generally occur in the middle ear and mastoid, whereas congenital cholesteatomas or epidermoids can occur in other locations, including the cerebellopontine angle, suprasellar cistern, calvarium, and multiple sites in the temporal bone. Congenital cholesteatomas compose only 2% of middle ear cholesteatomas. 2There are multiple theories regarding cholesteatoma development, but most authors believe there is a disruption of the normal process in which skin lining the tympanic membrane migrates externally within the external auditory canal. Retraction pockets, which are invaginations of the tympanic membrane into the middle ear cavity, develop and interfere with this process. These pockets are largely due to chronic otitis media and eustachian tube dysfunction, which can cause negative middle ear pressure. Retraction pockets occur most commonly in the pars flaccida of the membrane and less commonly in the pars tensa. Epithelial ingrowth may occur as a result of this process, and squamous debris can become trapped within these retraction pockets in the middle ear space.1,3 Many authors also believe that there is a hereditary predisposition to the development of acquired cholesteatomas. 2Complications of cholesteatomas are related to bony erosion. Erosion is generally thought to be related to mechanical pressure, though some believe that adjacent granulation tissue, an osteoclast stimulator, or collagenase production is necessary.1,2 Bony erosion can result in destruction of the ossicles, creating conductive hearing loss, labyrinthine fistulas with sensorineural hearing loss and vertigo, facial nerve canal erosion and facial paralysis, and rare intracranial complications, such as meningitis and abscess. 1,2The treatment for middle ear cholesteatomas is surgical excision. Small cholesteatomas limited to the Prussak space without significant bone erosion can often be effectively resected by using a transcanal atticotomy approach with subsequent tympanoplasty. Patients may undergo...

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Section: Patient Selectionmentioning

confidence: 90%

Section: Review Of the Literaturementioning

confidence: 99%

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The Utility of Diffusion-Weighted Imaging for Cholesteatoma Evaluation

Schwartz¹,

Lane²,

Bolster³

et al. 2010

AJNR Am J Neuroradiol

109

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“…Although Plouin-Gaudon et al (9) reported relatively low sensitivity, specificity, NPV, and PPV (62%, 88%, 89%, and 58%, respectively), most studies have reported a very high diagnostic performance for HASTE DWI that often reaches 100% for all four statistical measures (8). De Foer et al (19) have reported that the HASTE DWI detection limit for a cholesteatoma is as low as 2 mm; EPI DWI had previously set the limit of detection at 5 mm.…”

Section: Discussionmentioning

confidence: 99%

HASTE diffusion-weighted mri: reliability for detection of cholesteatoma

Ilıca¹,

Hıdır²,

Bulakbaşı³

et al. 2011

Diagn Interv Radiol

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“…However, when the middle ear is completely filled, CT is not reliable and MR imaging with late postgadolinium T1-weighting has an additional value. [1][2][3] Several authors showed interest in using diffusion-weighted MR imaging (DWI) for depicting recurrent cholesteatomas on a 1.5T imaging unit. Different methods were described to avoid artifacts on DWI present in this anatomic region.…”

mentioning

confidence: 99%

3T MR Imaging of Postoperative Recurrent Middle Ear Cholesteatomas: Value of Periodically Rotated Overlapping Parallel Lines with Enhanced Reconstruction Diffusion-Weighted MR Imaging

Lehmann¹,

Saliou²,

Brochart³

et al. 2008

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: MR diagnostic of postoperative recurrent cholesteatomas is difficult. Our purpose was to compare multishot fast spin-echo periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) diffusion-weighted MR imaging (DWI) with array spatial sensitivity encoding technique (ASSET) single-shot echo-planar DWI and late postgadolinium T1-weighted MR imaging for the detection of postoperative recurrent middle ear cholesteatomas with a 3T imaging unit.

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Value of high-resolution computed tomography and magnetic resonance imaging in the detection of residual cholesteatomas in primary bony obliterated mastoids

Cited by 44 publications

References 13 publications

The Utility of Diffusion-Weighted Imaging for Cholesteatoma Evaluation

The Utility of Diffusion-Weighted Imaging for Cholesteatoma Evaluation

HASTE diffusion-weighted mri: reliability for detection of cholesteatoma

3T MR Imaging of Postoperative Recurrent Middle Ear Cholesteatomas: Value of Periodically Rotated Overlapping Parallel Lines with Enhanced Reconstruction Diffusion-Weighted MR Imaging

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