scholarly journals Diffusion Weighted MR Imaging of Primary and Recurrent Middle Ear Cholesteatoma: An Assessment by Readers with Different Expertise

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
A. Elefante ◽  
M. Cavaliere ◽  
C. Russo ◽  
G. Caliendo ◽  
M. Marseglia ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Middle Ear ◽  
Spin Echo ◽  
Interrater Agreement ◽  
Lower Probability ◽  
Kappa Statistics ◽  
Single Shot ◽  
Predictive Values ◽  
Diffusion Weighted ◽  
Middle Ear Cholesteatoma

Introduction and Purpose. Diffusion weighted imaging (DWI) has been proven to be valuable in the diagnosis of middle ear cholesteatoma. The aims of our study were to evaluate the advantage of multi-shot turbo spin echo (MSh TSE) DWI compared to single-shot echo-planar (SSh EPI) DWI for the diagnosis of cholesteatoma.Material and Methods. Thirty-two patients with clinical suspicion of unilateral cholesteatoma underwent preoperative MRI (1.5T) with SSh EPI and MSh TSE. Images were separately analyzed by 4 readers with different expertise to confirm the presence of cholesteatoma. Sensitivity, specificity, diagnostic accuracy, and positive (PPV) and negative predictive values (NPV) were assessed for each observer and interrater agreement was assessed using kappa statistics. Diagnosis was obtained at surgery.Results. Overall MSh TSE showed higher diagnostic accuracy and lower negative predictive value (NPV) compared to conventional SSh EPI. Interreader agreement between the observers revealed the superiority of MSh TSE compared to SSh EPI. Interrater agreement among all the four observers was higher by using MSh TSE compared to SSh EPI.Conclusion. Our findings suggest that MSh TSE DWI has higher sensitivity for detection of cholesteatoma and lower probability of misdiagnosis. MSh TSE DWI is useful in guiding less experienced observers to the diagnosis.

The value of single-shot turbo spin-echo diffusion-weighted MR imaging in the detection of middle ear cholesteatoma

2007 ◽  
Vol 49 (10) ◽  
pp. 841-848 ◽  
Author(s):  
Bert De Foer ◽  
Jean-Philippe Vercruysse ◽  
Anja Bernaerts ◽  
Joachim Maes ◽  
Filip Deckers ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Middle Ear ◽  
Spin Echo ◽  
Single Shot ◽  
Turbo Spin Echo ◽  
Turbo Spin ◽  
Diffusion Weighted ◽  
Middle Ear Cholesteatoma

scholarly journals Cholesteatoma: multishot echo-planar vs non echo-planar diffusion-weighted MRI for the prediction of middle ear and mastoid cholesteatoma

BJR|Open ◽  
2019 ◽  
Vol 1 (1) ◽  
pp. 20180015 ◽  
Author(s):  
Cristina Dudau ◽  
Ashleigh Draper ◽  
Maria Gkagkanasiou ◽  
Geoffrey Charles-Edwards ◽  
Irumee Pai ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Middle Ear ◽  
Predictive Value ◽  
Spin Echo ◽  
Lesion Size ◽  
Single Shot ◽  
Diffusion Weighted ◽  
Echoplanar Imaging ◽  
Echo Planar ◽  
Good Agreement

Objective: We aimed to compare a newer readout-segmented echoplanar imaging (RS-EPI) technique with the established single shot turbo spin echo (SS-TSE) non-EPI diffusion-weighted imaging (DWI) in detecting surgically validated cholesteatoma. Methods: We retrospectively reviewed 358 consecutive MRI studies in 285 patients in which both RS-EPI and non-EPI DWI sequences were performed. Each diffusion sequence was reviewed independently and scored negative, indeterminate or positive for cholesteatoma in isolation and after reviewing the T1W sequence. Average artefacts scores were evaluated and the lesion size measured as a distortion indicator. The imaging scores were correlated with surgical validation, clinical and imaging follow-up. Results: There were 239 middle ear and central mastoid tract and 34 peripheral mastoid lesions. 102 tympanomastoid operations were performed. The positive predictive value ( PPV), post-operative PPV, primary PPV, negative predictive value were 93%, 95%, 87.5%, 70% for RS-EPI and 92.5%, 93.6%, 90%, 79% for non-EPI DWI. There was good agreement between the two techniques (k = 0.75). Non-EPI DWI is less susceptible to skull base artefacts although the mean cholesteatoma measurement difference was only 0.53 mm. Conclusion: RS-EPI has comparable PPV with non-EPI DWI in both primary and post-operative cholesteatoma but slightly lower negative predictive value. When there is a mismatch, non-EPI DWI better predicts the presence of cholesteatoma. There is good agreement between the sequences for cholesteatoma diagnosis. The T1W sequence is very important in downgrading indeterminate DWI signal lesions to a negative score. Advances in knowledge: This is, to our knowledge, the first study to compare a multishot EPI DWI technique with the established non- EPI DWI in cholesteatoma diagnosis.

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