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Value of T1-weighted Magnetic Resonance Imaging in Cholesteatoma Detection

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To reveal the usefulness of T1-weighted (T1W) imaging on diagnostic magnetic resonance (MR) imaging for cholesteatoma.

Study Design:

A retrospective case review.


Tertiary referral center.Patients:

Fifty-three patients (57 ears) suspected to have cholesteatomas and treated (6–82 yr of age).


Preoperative MR imaging, including non-echo planar (non-EP) diffusion-weighted (DW) and T1W imaging.

Main Outcome Measures:

Primary outcome measures included the comparison between the diagnostic accuracy for the detection of cholesteatomas using non-EP DW imaging alone (criterion 1) and non-EP DW imaging along with T1W imaging (criterion 2). Diagnostic accuracy was evaluated in each case by comparing MR imaging with surgical findings. Secondary outcome measures included the comparison of the rates of cases showing a high T1W signal between cholesteatomas and noncholesteatomas which showed a high non-EP DW signal.Results:

The sensitivity, specificity, and accuracy according to criterion 1 were 93.5, 63.6, and 87.7% and those according to criterion 2 were 89.1, 100, and 91.2%, respectively. Of 43 cholesteatoma cases indicating a high non-EP DW signal, only 2 cases showed a high T1W signal (5%). On the other hand, all four noncholesteatoma cases indicating high non-EP DW signal showed a high T1W signal (100%), and these rates were significantly different (p < 0.001).

Our results suggest that T1W imaging may aid in the exclusion of false-positive cases on diagnostic non-EP DW MR imaging for cholesteatomas. A combination of non-EP DW and T1W imaging may improve the specificity and accuracy compared with non-EP DW imaging alone.
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Keywords: Cholesteatoma; Cholesterol granuloma; Diffusion-weighted MR imaging; T1-weighted MR imaging

Document Type: Research Article

Affiliations: 1: Department of Otolaryngology—Head and Neck Surgery 2: Department of Radiation Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan

Publication date: December 1, 2017

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