Non-echo planar diffusion-weighted MRI increases follow-up accuracy after one-step step canal wall-down obliteration surgery for cholesteatoma. (June 2013)

• Record Type: Journal Article
• Authors: Edfeldt, Lennart; Strömbäck, Karin; Danckwardt-Lillieström, Niklas; Rask-Andersen, Helge; Abdsaleh, Shahin; Wikström, Johan
• Is Part Of: Acta oto-laryngologica. Volume 133:Number 6(2013)
• Page Start: 574
• Page End: 583
• Publication Date: 2013-06
• Subjects: Otolaryngology -- Periodicals; Ear -- Diseases -- Periodicals; Throat -- Diseases -- Periodicals; Otolaryngology -- Electronic Resources; Otorhinolaryngologic Diseases; 617.8
• DOI: 10.3109/00016489.2012.762118
• Languages: English
• ISSNs: 0001-6489

Abstract

<abstract> <title>Abstract</title> <p> <italic>Conclusion:</italic> 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. <italic>Objective:</italic> To evaluate the use of DW-MRI for detection of cholesteatoma after surgical treatment using a CWD obliteration technique. <italic>Methods:</italic> Thirty-eight adult patients (41 ears) treated with an identical one-step CWD 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 was 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. <italic>Results:</italic> Seven of 41 cases 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-EPI DW-MRI (<italic>p</italic> < 0.001) and –0.062 for EPI DW-MRI (<italic>p</italic> = 0.43)</p> </abstract>