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Role of non-echo-planar diffusion-weighted images in the identification of recurrent cholesteatoma of the temporal bone

  • Magnetic Resonance Imaging
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Abstract

Background and purpose

The aim of the present prospective study was to verify the specificity of non-EPI DWI-MRI in patients operated for middle ear CHO who showed positivity at imaging performed 6 to 9 months after surgery and underwent second-look surgery.

Materials and methods

All patients underwent 1.5-T non-EPI DWI-MRI 6 to 9 months after surgery: those showing a hyper-intense signal in the middle ear underwent a revision surgery, whilst the others are still under radiological follow-up and were not considered in this study. Two radiologists independently evaluated the images; both placed a standard region of interest inside the brightest part of the observed signal alteration on coronal HASTE-DWI images. The mean and maximum signal intensity values on the DWI images were recorded for each patient. A signal intensity ratio was calculated using the inferior temporal cortex and the background noise.

Results

One hundred and forty-three subjects were evaluated for a total of 210 ears. In 116 (170 ears), a normal non-EPI DWI-MRI was found with exclusion from this study, whilst twenty-seven subjects showed a high signal lesion inside the middle ear and underwent revision surgery. According to the ROC analysis, SI, SIRT and SIRTmax showed the best statistical values in comparison with the other parameters.

Conclusions

Residual/recurrent CHO can be accurately detected using quantitative evaluation of non-EPI DWI-MRI.

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Authors and Affiliations

  1. Department of Odontostomatological and Maxillo-Facial Sciences, Umberto I Hospital, University Sapienza, Via di Grottarossa, 00135, Rome, Italy

    Andrea Romano

  2. NESMOS, Department of Otorino-Laringoiatry, S. Andrea Hospital, University Sapienza, Rome, Italy

    Edoardo Covelli & Maurizio Barbara

  3. Department of Radioterapy, S. Andrea Hospital, University Sapienza, Rome, Italy

    Veronica Confaloni

  4. NESMOS, Department of Neuroradiology, S. Andrea Hospital, University Sapienza, Rome, Italy

    Andrea Romano, Maria Camilla Rossi-Espagnet, Giulia Butera & Alessandro Bozzao

  5. Neuroradiology Unit, Imaging Department, Bambino Gesù Children’s Hospital, Rome, Italy

    Maria Camilla Rossi-Espagnet

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  1. Andrea Romano
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  2. Edoardo Covelli
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  5. Giulia Butera
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Correspondence to Andrea Romano.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Romano, A., Covelli, E., Confaloni, V. et al. Role of non-echo-planar diffusion-weighted images in the identification of recurrent cholesteatoma of the temporal bone. Radiol med 125, 75–79 (2020). https://doi.org/10.1007/s11547-019-01085-x

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  • DOI: https://doi.org/10.1007/s11547-019-01085-x

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