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Cholesteatoma imaging using modified echo-planar diffusion-weighted magnetic resonance imaging

Published online by Cambridge University Press:  10 September 2010

E Flook ,
S Izzat  and
A Ismail
E Flook*
Affiliation:
ENT Department, Hope Hospital, Salford, UK
S Izzat
Affiliation:
ENT Department, Royal Albert Edward Hospital, Wigan, UK
A Ismail
Affiliation:
Radiology Department, Royal Albert Edward Hospital, Wigan, UK
*
Address for correspondence: Mr E Flook, 17 Willow Way, Manchester M20 6JT, UK E-mail: edflook@yahoo.com
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Abstract

Introduction:

Imaging of cholesteatomas can be useful especially in cases of recurrent disease. Computed tomography scans have been recommended before primary surgery, but cholesteatoma tissue looks similar to inflammatory tissue. Diffusion-weighted magnetic resonance imaging is both sensitive and specific in detecting cholesteatoma, which appears as a bright signal on a dark background. Non-echo-planar diffusion-weighted magnetic resonance imaging is superior to routine echo-planar diffusion-weighted magnetic resonance imaging as it minimises susceptibility artefacts; however, the addition of this facility involves expensive magnetic resonance scanner upgrading.

Method:

To avoid the cost of such upgrading, we modified our echo-planar diffusion-weighted magnetic resonance imaging parameters and then scanned 15 consecutive cases of suspected cholesteatoma or suspected recurrent cholesteatoma.

Results:

Imaging results correlated well with clinical and/or operative findings.

Conclusion:

These results indicate that software adjustments can enable echo-planar diffusion-weighted magnetic resonance imaging to detect cholesteatomas reliably, and as effectively as non-echo-planar diffusion-weighted magnetic resonance imaging. This discovery has the potential to facilitate reliable delayed post-operative screening of canal wall up mastoidectomies, avoiding the need for a ‘second look’ procedure.

Keywords

Magnetic Resonance ImagingDiffusion Magnetic Resonance ImagingCholesteatoma
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 1 , January 2011 , pp. 10 - 12
Copyright
Copyright © JLO (1984) Limited 2010

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Footnotes

Presented as a registrar paper at the North of England ENT Conference, 25th September 2009, Bradford, UK.

References

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