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Non echo planar, diffusion-weighted magnetic resonance imaging (periodically rotated overlapping parallel lines with enhanced reconstruction sequence) compared with echo planar imaging for the detection of middle-ear cholesteatoma

Published online by Cambridge University Press:  29 November 2010

A V Kasbekar ,
D J Scoffings ,
B Kenway ,
J Cross ,
N Donnelly ,
S W K Lloyd ,
D Moffat  and
P R Axon
A V Kasbekar*
Affiliation:
Departments of Otolaryngology, Cambridge University Hospitals NHS Trust, UK
D J Scoffings
Affiliation:
Departments of Radiology, Cambridge University Hospitals NHS Trust, UK
B Kenway
Affiliation:
Departments of Otolaryngology, Cambridge University Hospitals NHS Trust, UK
J Cross
Affiliation:
Departments of Radiology, Cambridge University Hospitals NHS Trust, UK
N Donnelly
Affiliation:
Departments of Otolaryngology, Cambridge University Hospitals NHS Trust, UK
S W K Lloyd
Affiliation:
Departments of Otolaryngology, Cambridge University Hospitals NHS Trust, UK
D Moffat
Affiliation:
Departments of Otolaryngology, Cambridge University Hospitals NHS Trust, UK
P R Axon
Affiliation:
Departments of Otolaryngology, Cambridge University Hospitals NHS Trust, UK
*
Address for correspondence: Mr Anand Kasbekar, Flat 7 38 Ye Priory Court Liverpool L25 7AY Fax: 0151 6047103 E-mail: anandkasbekar@doctors.org.uk
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Abstract

Objectives:

We evaluated use of the periodically rotated overlapping parallel lines with enhanced reconstruction diffusion-weighted imaging sequence, compared with conventional echo planar magnetic resonance imaging, in the detection of middle-ear cholesteatoma.

Material and methods:

Sixteen patients awaiting second-stage combined approach tympanoplasty and three patients awaiting first-stage combined approach tympanoplasty underwent magnetic resonance imaging with both (1) the periodically rotated overlapping parallel lines with enhanced reconstruction sequence (i.e. non echo planar imaging) and (2) the array spatial sensitivity encoding technique sequence (i.e. echo planar imaging). Two neuroradiologists independently evaluated the images produced by both sequences. Radiology findings were correlated with surgical findings.

Results and analysis:

Seven cholesteatomas were found at surgery. Neither of the assessed imaging sequences were able to detect cholesteatoma of less than 4 mm. Rates for sensitivity, specificity, and positive and negative predictive values are presented.

Conclusion:

Decisions on whether or not to operate for cholesteatoma cannot be made based on the two imaging sequences assessed, as evaluated in this study. Other contributing factors are discussed, such as the radiological learning curve and technical limitations of the magnetic resonance imaging equipment.

Keywords

Chronic Otitis MediaCholesteatomaMagnetic Resonance Imaging
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 4 , April 2011 , pp. 376 - 380
Copyright
Copyright © JLO (1984) Limited 2010

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