The role of magnetic resonance imaging in the postoperative management of cholesteatomas

Revista Brasileira de Otorrinolaringologia

Baraúna Filho, Iulo Sérgio¹  Toyama, Carlos¹  USP¹  Leite, Claudia da Costa¹  FMUSP¹  Gebrim, Eloisa Maria Melo Santiago¹  Cerri, Giovanni Guido¹  Bento, Ricardo Fereira¹  Brito Neto, Rubens Vuono de¹  Universidade de São Paulo¹ 

关键词: cholesteatoma;    diffusion;    mri.;   

DOI  :  10.1590/S0034-72992008000500009

学科分类：医学（综合）

来源: Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial

【 摘 要 】

Conventional CT and MRI scans have low specificity when it comes to differentiating granulation tissue from relapsing cholesteatoma. AIM: this paper aims to analyze the use of DWI and delayed post-contrast T1-weighed imaging in the detection of recurring cholesteatomas. MATERIALS AND METHOD: this is a cross-sectional prospective study that looked at 17 cholesteatoma patients postoperatively. All patients underwent diffusion magnetic resonance imaging at 1.5T, T1, T2, and delayed post-contrast T1 and images were produced from both coronal and axial planes. Two radiologists assessed the images and decided consensually that the presence of hyperintensive signal in DWI on T2, iso/hypointensive signal on T1, and absence of contrast uptake were indicative of relapsing cholesteatoma. Surgical review findings were compared to DWI scans. RESULTS: eleven of the twelve cases of recurring cholesteatoma presented hyperintensive signal in the DWI scans. None of the patients with granulation tissue in the surgical wound presented hyperintensive signal in the DWI scans. A patient with an abscess in the internal acoustic meatus also presented a hyperintensive signal in the DWI scans. Sensibility, specificity, positive predictive value and negative predictive value were 91.6%, 60.0%, 84.6%, and 75.0%, respectively. CONCLUSION: DWI combined with delayed post-contrast T1 SE sequence proved to be useful in the differential diagnosis of granulation tissue and recurring cholesteatoma.

【 授权许可】

Unknown