Non-EPI DW MRI in Planning the Surgical Approach to Primary and Recurrent Cholesteatoma

Abstract

Primary and residual/recurrent cholesteatoma was accurately detected on non-EPI DWI with 98% clinical and radiologic concordance. Lesions less than 8 mm confined to the middle ear and its extensions can be eradicated with a minimally invasive endoscopic transcanal technique, whereas endoscope-assisted retroauricular mastoidectomy is preferred for larger lesions.

Diagnostic Capacity of Non-echo Planar Diffusion-weighted MRI in the Detection of Primary and Recurrent Cholesteatoma

“…9 Actually, non-EPI DW MRI is the most sensitive and specific of all imaging techniques available for the diagnosis of cholesteatoma 10 helping to develop criteria in surgical planning in some cases. 11 The purpose of this study is to compare the non-EPI DW MRI findings to the pathology after surgery, which, evidently, either confirms or excludes the diagnosis.…”

Diffusion-Weighted Intensity Magnetic Resonance in the Preoperative Diagnosis of Cholesteatoma

“…Such hyperintensity can also be quantified using an objective parameter called ADC (apparent diffusion coefficient), calculated for each pixel of the image until obtaining a map of the lesion [6]. A specific sequence of DWI-MR, the multi-shot turbo spin-echo (MSh-TSE) not-echo planar imaging (EPI), has been reported recently [18,19] to be more reliable in the differential diagnosis of cholesteatoma, since it offers an improved spatial resolution (>3 mm) and reduces potential artifacts due to the air-bone interface. However, the latter involves longer acquisition times than traditional EPI sequences.…”

Efficacy and Safety of Transcanal Endoscopic Ear Surgery for Congenital Cholesteatomas

“…These stage III CCs might be operated by TEES if accurate size and location of CCs could be evaluated preoperatively. When the mastoid is not aerated, we should take nonecho planar diffusion weighted magnetic resonance imaging before performing TEES (23,24) to avoid unnecessary tympanomastoidecomy. Presently, it is unclear whether TEES can reduce the residual rate of CCs.…”