Limitations of non-echo planar diffusion weighted magnetic resonance imaging (non-EPI MRI) in cholesteatoma surveillance after ossicular chain reconstruction. A prospective study |
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| Authors: | Judit Kálmán Tamás Horváth Bálint Liktor Kornél Dános László Tamás Mária Gődény Gábor Polony |
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| Affiliation: | 1. Department of Otorhinolaryngology - Head and Neck Surgery, Bajcsy-Zsilinszky Hospital, Budapest, Hungary;2. Department of Otorhinolaryngology - Head and Neck Surgery, Semmelweis University, Budapest, Hungary;3. Department of Diagnostic Radiology, National Institute of Oncology, Budapest, Hungary;1. Department of Otolaryngology-Head and Neck Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan;2. Department of Oral Surgery, Kyorin University School of Medicine, Tokyo, Japan;1. Sen-En Rifu Otological Surgery Center, Miyagi, Japan;2. Department of Otolaryngology-Head and Neck Surgery, Tohoku University School of Medicine, 1 1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan;3. Department of Neurosurgery, Southern Tohoku General Hospital, Fukushima, Japan;1. University of Health Sciences, Faculty of Health Sciences, Department of Audiology, Istanbul, Turkey;2. Istanbul Aydin University, Faculty of Health Sciences, Department of Audiology, Istanbul, Turkey;1. Department of Otorhinolaryngology, University of Health Science Turkey, Gülhane Traning and Research Hospital, Ankara, Turkey;2. Department of Audiology, University of Health Science Turkey, Gülhane Faculty of Health Science, Ankara, Turkey;3. Department of Otorhinolaryngology, University of Health Science Turkey, Gülhane Faculty of Medicine, Ankara, Turkey;1. Otorhinolaryngology, Faculty of Medicine, Kafr Elsheikh University, Egypt;2. Otorhinolaryngology, Faculty of Medicine, Tanta University, Egypt |
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| Abstract: | ObjectiveNon-echo planar diffusion weighted magnetic resonance imaging is a reliable surveillance tool of residual cholesteatoma nowadays. It is not known whether the material of the ossicular chain prosthesis modifies the sensitivity and specificity of MRI in these cases. The aim of the study was to compare the sensitivity, specificity and a localization-specific accuracy of non-EPI DW MRI sequences for residual cholesteatoma in the following 3 subgroups: patients with titanium ossicular prosthesis (group T), with autologous cortical bone columella (group A) or without any reconstruction (group WR) of hearing bones.MethodsThis prospective study covered 28 cases with cholesteatoma of the middle ear undergone second-look surgery, who had preoperative PROPELLER DW-MRI. Surgical findings were compared to the results of the DWI-MRI.ResultsThe overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were: 0.76-0.8-0.76-0.8. Group T, group A and group WR sensitivity was 0.83-0.6-1, specificity: 0.75-0.75-0.85, PPV: 0.83-0.75-0.66, NPV: 0.75-0.6-1. Overall accuracy was 0.78. Size of missed cholesteatoma was 2-4 mm (mean: 2.66±1.15).ConclusionsVarious materials are suitable for ossicular chain reconstruction. The poor detectability of residual or recurrent cholesteatoma in the middle ears reconstructed with autologous bony prosthesis may still claim second-look surgery instead of the usage of non- EPI DWI sequences independently in these patients. |
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