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
References
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Dynamic Contrast-Enhanced MR and T2 Relaxation Time...