Value of diffusion-weighted MR imaging in the detection of middle ear cholesteatoma

Abstract

[Objective] This study was conducted to determine the clinical value of diffusion-weighted MR imaging (DWI) in detecting the presence of cholesteatoma. [Subject and methods] Fifty-six patients (21 female and 35 male patients ; mean age, 43 years) who underwent middle ear surgery were referred to the radiology department for a preoperative DWI study. [Results] DWI depicted 41 out of 48 cholesteatomas involving the middle ear cavity (sensitivity, 85.4%). Seven patients with middle ear cholesteatoma who showed negative DWI findings (false-negative cases) had limited keratin accumulation due to simple atelectasis or meticulous evacuation of keratin debris before the MRI study. No false-positive cases were found in this study (specificity, 100%). The positive predictive value and negative predictive value were 100% and 53.3%, respectively. The minimum size of middle ear cholesteatoma detected by the current MRI system was 5mm. [Conclusion] Diffusion-weighted MR imaging was useful for the detection of middle ear cholesteatoma.