Value of Diffusion-weighted MR Imaging in the Detection of Middle Ear Cholesteatoma

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  • Nagai Noriaki
    Department of Otolaryngology-Head and Neck Surgery, Miyazaki University School of Medicine
  • Tono Tetsuya
    Department of Otolaryngology-Head and Neck Surgery, Miyazaki University School of Medicine
  • Matsuda Keiji
    Department of Otolaryngology-Head and Neck Surgery, Miyazaki University School of Medicine
  • Toyama Katsuhiro
    Department of Otolaryngology-Head and Neck Surgery, Miyazaki University School of Medicine
  • Kawano Hirokazu
    Department of Otolaryngology-Head and Neck Surgery, Miyazaki University School of Medicine
  • Kodama Takao
    Department of radiology, Miyazaki University School of Medicine

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Other Title
  • 中耳真珠腫診断におけるＭＲＩ拡散強調像の有用性
  • チュウジ シンジュシュ シンダン ニ オケル MRI カクサン キョウチョウゾウ ノ ユウヨウセイ

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[Objective] This study was conducted to determine the clinical value of diffusion-weighted MR imaging (DWI) in detecting the presence of cholesteatoma.<br>[Subject and methods] Fifty-six patients (21 female and 35 male patients ; mean age, 43 years) who underwent middle ear surgery were referred to the radiology department for a preoperative DWI study.<br>[Results] DWI depicted 41 out of 48 cholesteatomas involving the middle ear cavity (sensitivity, 85.4%). Seven patients with middle ear cholesteatoma who showed negative DWI findings (false-negative cases) had limited keratin accumulation due to simple atelectasis or meticulous evacuation of keratin debris before the MRI study. No false-positive cases were found in this study (specificity, 100%). The positive predictive value and negative predictive value were 100% and 53.3%, respectively. The minimum size of middle ear cholesteatoma detected by the current MRI system was 5mm.<br>[Conclusion] Diffusion-weighted MR imaging was useful for the detection of middle ear cholesteatoma.

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