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Reliability of diffusion-weighted magnetic resonance imaging in differentiation of recurrent cholesteatoma and granulation tissue after intact canal wall mastoidectomy

Published online by Cambridge University Press:  18 November 2019

H S Allam ,
A A K Abdel Razek ,
B Ashraf  and
M Khalek
H S Allam
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Mansoura University Faculty of Medicine, Egypt
A A K Abdel Razek*
Affiliation:
Department of Diagnostic Radiology, Mansoura University Faculty of Medicine, Egypt
B Ashraf
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Mansoura University Faculty of Medicine, Egypt
M Khalek
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Mansoura University Faculty of Medicine, Egypt
*
Author for correspondence: Dr Ahmed Abdel Khalek Abdel Razek, Department of Diagnostic Radiology, Mansoura University Faculty of Medicine, 60 Elgomheryia Street, Mansoura, Egypt3512 E-mail: arazek@mans.edu.eg Fax: +20 502 259 146
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Abstract

Objective

To assess the reliability of diffusion-weighted magnetic resonance imaging in differentiating recurrent cholesteatoma from granulation tissue after intact canal wall mastoidectomy.

Methods

A prospective study was conducted of 56 consecutive patients with suspected cholesteatoma recurrence after intact canal wall mastoidectomy who underwent diffusion-weighted imaging and delayed contrast magnetic resonance imaging of the temporal bone. The final diagnosis was recurrence in 38 patients and granulation tissue in 18 patients.

Results

Cholesteatoma detection on diffusion-weighted imaging based on two sets of readings had sensitivity of 94.7 and 94.7 per cent, specificity of 94.4 and 88.9 per cent, and accuracy of 94.6 and 92.8 per cent, with good intra-observer agreement (Κ = 0.72, p = 0.001). Cholesteatoma detection on delayed contrast magnetic resonance imaging had sensitivity of 81.6 and 78.9 per cent, specificity of 77.8 and 66.7 per cent, and accuracy of 80.4 and 75.0 per cent, with fair intra-observer agreement (Κ = 0.57, p = 0.001). The mean cholesteatoma diameter on diffusion-weighted imaging was 7.7 ± 1.8 and 7.9 ± 1.8 mm, with excellent intra-observer agreement (Κ = 0.994, p = 0.001).

Conclusion

Diffusion-weighted imaging is a reliable method for differentiating recurrent cholesteatoma and granulation tissue after intact canal wall mastoidectomy.

Keywords

CholesteatomaDiffusion-Weighted MRIMagnetic Resonance Imaging
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 12 , December 2019 , pp. 1083 - 1086
Copyright
Copyright © JLO (1984) Limited, 2019

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Footnotes

Dr A A K Abdel Razek takes responsibility for the integrity of the content of the paper

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