CT and MRI Fusion imaging in select cases of cholesteatoma recurrence

Congress:

ECR 2019

Poster Number:

C-2242

Type:

Educational Exhibit

Keywords:

Head and neck, Computer applications, Ear / Nose / Throat, Image manipulation / Reconstruction, CT, MR, Computer Applications-3D, Technical aspects, Localisation, Image verification, Tissue characterisation, Image registration

Authors:

A. Kusak, O. Rosiak, M. Durko, M. T. Podgórski, P. Grzelak, W. Pietruszewska; Lodz/PL

DOI:

10.26044/ecr2019/C-2242

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-2242

Fig. 1: (A) – Fusion image (BFFE, non-epi DWI + HRCT); (B) – non-EPI DWI b=1000, C...

Fig. 3: BFFE and DWI non EPI b1000

Fig. 4: Results

Fig. 2: MRI and CT used during study

Learning objectives

In post surgical cases suspected of cholesteatoma recidivism imaging is crucial for determining the extent of the disease and location. MR non-echoplanar diffusion weighted imaging detects cholesteatoma with sensitivity reaching 91,4%, high positive predictive value of 97,3% and negative predictive value of up to 85% making it a valuable tool in detecting recurrence. CT provides detailed images of bone anatomy with spatial relevance to anatomical landmarks of the middle ear cavity, however in post-operative evaluation it’s ability for differentiating between cholesteatoma and other tissues is...

Background

Patients treated at Department of Otolarygology, MU in Lodz with suspicion of cholesteatoma at least 1 year post surgery with no otoscopic evidence of recurrence were included in this study. MRI and a HR petrous bone CT scan was obtained. The BFFE, non-epi DWI and CT images were then fused using Osirix MD software. Patients with radiological confirmation of recurrence were scheduled for revision surgery, excised tissue was then evaluated histopathologicaly to confirm diagnosis.

Findings and procedure details

To the study five patients were included. Two of them were post CWD and three post CWU. In all cases there were suspicion of cholesteatoma recidivism. During operation in four cases of cholesteatoma were confirmed. One case revealed planar adhesions without cholesteatoma.

Conclusion

Non-EPI DWI and HRCT fusion is a valuable tool in planning revision surgery. It allows excellent cholesteatoma localization in the temporal bone relative to anatomical landmarks

Personal information

References

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