The Value of Diffusion-Weighted Magnetic Resonance Image in the Evaluation of Temporal Bone Cholesteatoma | ||
Iraqi Postgraduate Medical Journal | ||
Article 17, Volume 21, Issue 1, January 2022, Pages 120-126 PDF (271 K) | ||
DOI: 10.52573/ipmj.2021.174080 | ||
Authors | ||
Sura Jwad1; Mohammed AL Hilly2 | ||
1Welfare Teaching Hospital, Medical City, Baghdad, Iraq | ||
2Al Shaheed Ghazi AL Hairri Teaching Hospital, Medical City, Baghdad, Iraq | ||
Abstract | ||
BACK GROUND : Cholesteatoma is non-neoplastic destructive lesion .MRI including diffusion weighted imaging (DWI) is helpful, since high content of keratin is associated with restricted diffusion. AIM OF STUDY: To determine the value of DWMRI and apparent diffusion coefficient (ADC) value in diagnosis of temporal bone cholesteatoma . PATIENTS AND METHOD : A prospective study conducted 33 patients with clinical suspicious of cholestatoma using 1.5tesla MRI scanner ,DWI with bvalue 1000 sec/ mm2.ADC was reconstructed and mean value measured in mm2/sec for each lesion .Enhancing image obtained after intravenous contrast administration with early and delay images in suspected recurrent cases . RESULT: DWI accurately detect 22 of 25 cholesteatoma lesions (sensitivity = 88% and specificity = 100%).Positive predictive value and negative predictive value were 100% and76.9% respectively with accuracy rate 91.4%. ADC value revealed (0.469 x10-3 to 0.823 x10-3 mm2/sec) for restricted lesions with mean value ( 0.653 x10-3 ± 0.09092 SD mm2 /sec)which is significantly difference from non restricted lesions(P value less than 0.001) .T1W post contrast images also give high accuracy in diagnosis of cholesteatoma 23 from 25 cases (sensitivity =92.59 %, specificity = 100). CONCLUSION: MRDWI give high accuracy in detection of cholestatoma in patient with chronic ear discharge. | ||
Keywords | ||
cholesteatoma; Magnetic resonance image; Diffusion weighted image; Temporal bone | ||
References | ||
10. Khedr SA, Adly AM, Fathi A, El Fiky L, Obaid A. Role of diffusion-weighted MRI in the detection of cholesteatoma after tympanoplasty. Egyptian Journal of Ear, Nose, Throat and Allied Sciences. 2011;12:141-48.
11. Vaid S, Kamble Y, Vaid N, Bhatti S, Rawat S, Nanivadekar A, Karmarkar S. Role of magnetic resonance imaging in cholesteatoma: the Indian experience. Indian Journal of Otolaryngology and Head & Neck Surgery. 2013;65:485-92.
12. Stasolla A, Magliulo G, Parrotto D, Luppi G, Marini M. Detection of postoperative relapsing/residual cholesteatomas with diffusion-weighted echo-planar magnetic resonance imaging. Otology &Neurotology. 2004;25:879-84.
13. Fitzek C, Mewes T, Fitzek S, Mentzel HJ, Hunsche S, Stoeter P. Diffusion‐weighted MRI of cholesteatomas of the petrous bone. Journal of Magnetic Resonance Imaging. 2002;15:636-41.
14. Yiğiter AC, Pınar E, İmre A, Erdoğan N. Value of Echo-Planar Diffusion-Weighted Magnetic Resonance Imaging for Detecting TympanomastoidCholesteatoma. The journal of international advanced otology. 2015;11:53-57.
15. Cabellos JB, Vélez SO, Cáceres IA, Lluch ES, Monje JG. CT and MRI Correlations in Patients with Suspected Cholesteatoma after Surgery. The neuroradiology journal. 2011;24:367-78.
16. Lingam RK, Khatri P, Hughes J, Singh A. Apparent diffusion coefficients for detection of postoperative middle ear cholesteatoma on non–echo-planar diffusion-weighted images. Radiology. 2013;269:504-10.
| ||
Statistics Article View: 60 PDF Download: 58 |