ENT Updates

Clinical Research

Diagnostic Performance of Diffusion-Weighted Magnetic Resonance Imaging in Patients with Cholesteatoma

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https://doi.org/10.32448/entupdates.508078
Kayalı Dinç, A. S., Damgacı, L., Çayönü, M., Sözmen Cılız, D., Boynueğri, S., Melih Şahin, M., Gül Hatipoğlu, H., Dogan, N., & Eryilmaz, A. (2018). Diagnostic Performance of Diffusion-Weighted Magnetic Resonance Imaging in Patients with Cholesteatoma. ENT Updates, 8(3). https://doi.org/10.32448/entupdates.508078
Volume 8 Issue 3 (2018)
Copyright (c) 2018 A. Secil Kayalı Dinç, Lale Damgacı, Melih Çayönü, Deniz Sözmen Cılız, Süleyman Boynueğri, M. Melih Şahin, H. Gül Hatipoğlu, Naciye Dogan, Adil Eryilmaz
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This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors

  • A. Secil Kayalı Dinç
    Ankara Numune Training and Research Hospital, Department of Otorhinolaryngology and Head Neck Surgery, Ankara, Turkey
  • Lale Damgacı Ankara Numune Training and Research Hospital, Department of Radiology, Ankara, Turkey
  • Melih Çayönü Ankara Numune Training and Research Hospital, Department of Otorhinolaryngology and Head Neck Surgery, Ankara, Turkey
  • Deniz Sözmen Cılız Ankara Numune Training and Research Hospital, Department of Radiology, Ankara, Turkey
  • Süleyman Boynueğri Ankara Numune Training and Research Hospital, Department of Otorhinolaryngology and Head Neck Surgery, Ankara, Turkey
  • M. Melih Şahin Ankara Numune Training and Research Hospital, Department of Otorhinolaryngology and Head Neck Surgery, Ankara, Turkey
  • H. Gül Hatipoğlu Ankara Numune Training and Research Hospital, Department of Radiology, Ankara, Turkey
  • Naciye Dogan Ankara Numune Training and Research Hospital, Department of Otorhinolaryngology and Head Neck Surgery, Ankara, Turkey
  • Adil Eryilmaz Ankara Numune Training and Research Hospital, Department of Otorhinolaryngology and Head Neck Surgery, Ankara, Turkey

Objective: Our aim was to evaluate the diagnostic performance of Magnetic Resonance Imaging (MRI) with diffusion-weighted images in patients with cholesteatoma.

Methods: We compared the preoperative MRI findings and intraoperative microscopic examination findings in 54 patients who were operated on due to a pre-diagnosis of chronic otitis media with cholesteatoma, according to preoperative microscopic ear examination, temporal bone computed tomography (CT) and ear MRI.

Results: Fifty-four patients (18 female and 36 male) were enrolled in this study. The mean age was 36.8 ± 17.3 (range: 6-67). Thirty-one patients had primary surgery, whereas 23 patients had revision surgery to the affected ear (for 19 patients, the second, for 3, the third, and for 1, the 5th operation).We found that the sensitivity of pre-operative MRI for detecting cholesteatoma was 97.7%, the specificity was 77.8%, and the diagnostic accuracy rate was 94.4%. The rate of false negatives in MRI with diffusion-weighted images was found to be 4% in primary cases, whereas the false negativity rate with this technique was found to be 0% for revision cases.

Conclusion: We concluded that ear MRI examination with diffusion-weighted images is a significant diagnostic tool, to be used alongside preoperative history and physical examination in deciding on whether to operate, especially in patients for whom revision surgery of the ear (due to recurrent, residual, iatrogenic cholesteatoma, or squamous epithelium) is planned.

Keywords:

Cholesteatoma Magnetic resonance imaging sensitivity specificity