Radiology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
QUICK SEARCH:   [advanced]


     

Published online before print November 22, 2005, 10.1148/radiol.2381041649

(Radiology 2005;238:604.)

A more recent version of this article appeared on January 1, 2005
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow All Versions of this Article:
2381041649v1
238/2/604    most recent
Right arrow Submit a response
Right arrow View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Dubrulle, F.
Right arrow Articles by Vincent, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Dubrulle, F.
Right arrow Articles by Vincent, C.
© RSNA, 2005

Head and Neck Imaging

Diffusion-weighted MR Imaging Sequence in the Detection of Postoperative Recurrent Cholesteatoma1

Frederique Dubrulle, MD, Raphaelle Souillard, MD, David Chechin, PhD, François M. Vaneecloo, MD, Alain Desaulty, MD and Christophe Vincent, MD

1 From the Departments of Radiology (F.D., R.S.), Otology and Otoneurosurgery (C.V., F.M.V.), and Otolaryngology (A.D.), Centre Hospitalier Universitaire, Lille, France; and Philips Medical Systems, Suresnes, France (D.C.). Received September 24, 2004; revision requested November 30; revision received January 21, 2005; accepted February 21; final version accepted March 18. Address correspondence to: F.D., Plateau Commun d'Imagerie, Hôpital Claude Huriez Centre Sud, Rue Michel Polonovski, 59037 Lille Cedex, France (e-mail: f-dubrulle{at}chru-lille.fr).

Purpose: To prospectively evaluate a fast spin-echo (SE) diffusion-weighted sequence for magnetic resonance (MR) imaging of recurrent cholesteatoma in patients who have undergone middle ear surgery.

Materials and Methods: The study was approved by the institutional review board, and informed consent was obtained from all patients. Twenty-four patients (10 female and 14 male patients; mean age, 44 years) who had undergone resection of cholesteatoma were referred for MR imaging. MR imaging was performed with a 1.5-T unit by using unenhanced diffusion-weighted fast SE imaging at b factors of 0 and 800 sec/mm2, unenhanced T2-weighted fast SE imaging, unenhanced T1-weighted SE imaging, and delayed contrast material–enhanced T1-weighted imaging. Two radiologists evaluated the diffusion-weighted fast SE images for the presence of a high-signal-intensity cholesteatoma. Results from MR imaging were compared with reports from second- or third-look surgery. Interobserver agreement was assessed with the {kappa} statistic.

Results: A recurrent cholesteatoma was correctly identified in 13 of 14 patients with diffusion-weighted fast SE images obtained with a b factor of 800 sec/mm2, for a positive predictive value of 93%. In patients without recurrent cholesteatoma, all diffusion-weighted fast SE MR images obtained with a b factor of 800 sec/mm2 were correctly interpreted as showing no high signal intensity. Thus, the negative predictive value was 100%. Sensitivity and specificity were 100% (13 of 13 patients) and 91% (10 of 11 patients), respectively. Interobserver agreement was excellent ({kappa} = 0.92). The smallest recurrent cholesteatoma was 5 mm in diameter, and this was correctly detected with the diffusion-weighted fast SE sequence.

Conclusion: Diffusion-weighted fast SE imaging enables the depiction of recurrent cholesteatoma in patients who have undergone middle ear surgery.

© RSNA, 2005




eLetters:

Read all eLetters

Optimal Detection of Postoperative Residual Cholesteatoma with MR Imaging
Marc T Williams, MD
Radiology Online, 8 Mar 2006 [Full text]