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Jun 26, 2018

BACO International 2018

Using Non-echoplanar diffusion weighted MRI in detecting cholesteatoma following Canal Wall Down mastoidectomy – Our Experience with 20 patient episodes

;

Andrew Hall, Ravi Lingam;

Arvind Singh

diagnostic imaging

diffusion magnetic resonance imaging

cholesteatoma

Abstract

Abstract

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Keywords

diagnostic imaging

diffusion magnetic resonance imaging

cholesteatoma

Abstract

Objective: At present, there is no data exploring specifically the diagnostic performance of Diffusion weighted imaging (DWI) in patients with previous canal wall down (CWD) surgery when combined with appropriate clinical evaluation. This study therefore aims to evaluate the performance of DWI in the detection of residual or recurrent disease in patients who have had a previous CWD mastoidectomy. Materials and Methods: We identified 13 patients with a CWD mastoidectomy subsequently having at least one further DWI prior to further mastoid exploration which generated a total of 20 patient episodes. Magnetic resonance imaging was performed on a 1.5-T superconductive unit (MagnetomAvanto; Siemens Medical Solutions, Erlangen, Germany) using a standard Head Matrix coil. Coronal 2-mm-thick TSE T2-weighted images (TR 4640 ms; TE 103ms; matrix 245384; field of view 150x200mm) were performed. Operative findings were reviewed for all 20 patient episodes to compare DWI findings to intraoperative findings. On this basis sensitivity, specificity, Positive predictive value (PPV), negative predictive value (NPV) and accuracy were calculated. Results: DWI was found to have a sensitivity of 93%, specificity of 60%, PPV of 87%, NPV of 75% and Accuracy of 80% Conclusion: Given the high sensitivity of DWI in detecting residual or recurrent disease, this study supports DWI as a useful tool in detecting residual or recurrent cholesteatoma in cases following CWD surgery, where clinical acumen suggests an ongoing disease process despite no overt cholesteatoma being visible.

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© Copyright 2019 Morressier GmbH.
All rights reserved.