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

Edfeldt, Lennart,1950-Uppsala universitet,Öron-, näs- och halssjukdomar (author)

Conclusion: 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.Objective: To evaluate the use of DW-MRI for detection of cholesteatoma after surgical treatment using CWD obliteration technique.Methods: 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.Results: 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)

Strömbäck, KarinUppsala universitet,Öron-, näs- och halssjukdomar(Swepub:uu)karst188 (author)
Danckwardt-Lillieström, NiklasUppsala universitet,Öron-, näs- och halssjukdomar(Swepub:uu)nidan839 (author)
Rask-Andersen, HelgeUppsala universitet,Öron-, näs- och halssjukdomar(Swepub:uu)helgraan (author)
Abdasaleh, ShahinUppsala universitet,Institutionen för radiologi, onkologi och strålningsvetenskap (author)
Wikström, JohanUppsala universitet,Enheten för radiologi(Swepub:uu)jwi06759 (author)
Uppsala universitetÖron-, näs- och halssjukdomar (creator_code:org_t)

In:Acta Oto-Laryngologica: Informa UK Limited133:6, s. 574-5830001-64891651-2251

By the author/editor: Edfeldt, Lennart ...; Strömbäck, Karin; Danckwardt-Lilli ...; Rask-Andersen, H ...; Abdasaleh, Shahi ...; Wikström, Johan

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Neurology

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