Non-echo planar diffusion-weighted MRI increases follow-up accuracy after one-step step canal wall-down obliteration surgery for cholesteatoma
2013 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, Vol. 133, no 6, 574-583 p.Article in journal (Refereed) Published
Non-echo planar (non-EPI) diffusion-weighted (DW) magnetic resonance imaging (MRI) increases the number of detected cholesteatoma after one-step canal-wall down (CWD) obliteration surgery for cholesteatoma compared with clinical evaluation alone.
To evaluate the use of DW-MRI for detection of cholesteatoma after surgical treatment using CWD obliteration technique.
Thirty-eight adult patients (41 ears) treated with identical one-step canal-wall down obliteration surgical technique were included in a prospective and blinded study. All patients were investigated with non-EPI and EPI DW-MRI 1-9 months after the clinical examination. Follow-up time after primary surgery varied between 10 and 234 months. DW-MRI were assessed by two neuroradiologists and compared with clinical results. Inter-rater agreement was calculated. Positive non-EPI DW-MRI cases underwent revision surgery within 18-159 days after imaging.
Out of 41 cases seven were evaluated as positive for cholesteatoma on non-EPI DW-MRI. Since one patient refused surgery six of these seven cases underwent surgical revision and all were verified. There was agreement between clinical and non-EPI findings in five of eight cases. EPI findings correlated poorly with non-EPI and clinical findings. Inter-rater agreement (Cohen´s kappa) was 0.91 for non-EPIDW-MRI (p<0.001) and -0.062 for EPI DW-MRI (p=0.43)
Place, publisher, year, edition, pages
2013. Vol. 133, no 6, 574-583 p.
IdentifiersURN: urn:nbn:se:uu:diva-198119DOI: 10.3109/00016489.2012.762118ISI: 000319011800003PubMedID: 23675808OAI: oai:DiVA.org:uu-198119DiVA: diva2:615258