HASTE diffusion-weighted MRI for the reliable detection of cholesteatoma

• Published in: Diagnostic and interventional radiology (Ankara, Turkey) Turkey), 2012-03, Vol.18 (2), p.153-158
• Main Authors: Ilıca, A Turan, Hıdır, Yusuf, Bulakbaşı, Nail, Satar, Bülent, Güvenç, Inanç, Arslan, Hasan Hüseyin, Imre, Nurcan
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Cholesteatoma, Middle Ear - diagnosis; Cholesteatoma, Middle Ear - pathology; Cholesteatoma, Middle Ear - surgery; Cohort Studies; Diffusion Magnetic Resonance Imaging - methods; Female; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging - methods; Male; Middle Aged; Otologic Surgical Procedures - methods; Prospective Studies; Recurrence; Reference Values; Reoperation - methods; Reproducibility of Results; Sensitivity and Specificity; Severity of Illness Index; Young Adult
• ISSN: 1305-3825; 1305-3612
• DOI: 10.4261/1305-3825.DIR.4246-11.3

To assess the detection efficiency of Half-Fourier acquisition single-shot turbo spin-echo (HASTE) diffusion-weighted magnetic resonance imaging (MRI) for cholesteatoma. A total of 21 patients with suspected primary (n=16) or recurrent cholesteatoma (n=5) underwent MRI in a 1.5 Tesla scanner using an adapted protocol for cholesteatoma detection that included a coronal HASTE diffusion-weighted MRI sequence. The cholesteatoma diagnosis was based on evidence of a hyperintense lesion at b-1000 on diffusion-weighted images. The imaging findings were correlated with findings from surgery or clinical evaluations in all patients. HASTE diffusion-weighted MRI successfully detected 11 primary and 5 recurrent lesions out of 17 cholesteatomas (sensitivity, 94.1%). One primary cholesteatoma with a diameter of 4-5 mm was missed. MRI of patients without cholesteatoma were correctly interpreted as negative for cholesteatoma (specificity, 100%). The positive and negative predictive values for the HASTE diffusion-weighted MRI in detecting cholesteatoma were 100% and 80%, respectively. HASTE diffusion-weighted MRI offers great promise for cholesteatoma screening. The addition of this sequence to the posterior fossa MRI protocol may preclude unnecessary cholesteatoma surgery.