Evaluating the effectivenss of diffusion weighted MRI in diagnosis of middle ear cholesteatoma

Abstract

Background The study aims to evaluate the effectiveness of diffusion-weighted (DW)-MRI in detecting middle-ear cholesteatoma and compare it with the intraoperative findings and histopathological results. Patients and methods From 40 cases of cholesteatoma, we performed diffusion-weighted imaging (DWI) on 20 patients suspected of having middle-ear cholesteatoma. MRI was performed with 1.5-T units using DWI. Results From the 20 cases we examined, 14 (70%) cases showed areas of DWI restriction within the middle ear denoting cholesteatoma and six cases were negative for cholesteatoma on DWIs. We compared the results with intraoperative findings and histopathological results and we found that the DW-MRI had the sensitivity of 93.3%, specificity of 100%, positive predictive value of 100%, negative predictive value of 83.3%, and accuracy of 95%. Conclusion DWI is a beneficial tool in the evaluation of middle-ear cholesteatoma with excellent specificity and positive predictive value. DW-MRI can predict and localize cholesteatoma with higher diagnostic rates compared with high-resolution computed tomography scan, but the anatomical details are shown obviously in high-resolution computed tomography scan.