Diffusion Weighted Imaging and Enhanced MRI in Diagnosing Primary and Residual/Recurrent Cholesteatoma | ||||
| Al-Azhar International Medical Journal | ||||
| Volume 2025, Issue 1, January 2025 | ||||
| DOI: 10.58675/2682-339X.2866 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Mohamed Elfeshawy1; Ahmed Elsamanody2 | ||||
| 1Diagnostic and Interventional Radiology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt | ||||
| 2Otorhinolaryngology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: It is still challenging to recognize a primary or residual cholesteatoma using imaging methods. Otoscopic abnormalities, hearing loss, and otorrhea are the main clinical suspicions for cholesteatoma. Aim of the study: To determine and assess the specificity and sensitivity of the diffusion weighted imaging (DWI) with magnetic resonance imaging (MRI) for the identification of primary acquired and residual cholesteatoma, with confirmation from surgy in every case. Patients and methods: Using MRI and non-echoplanar DWI. Forty individuals were assessed. The first 22 subjects were evaluated to diagnose primary acquired cholesteatoma. A total of 18 patients were evaluated for residual cholesteatoma 12–24 months after initial cholesteatoma surgery in the group that underwent second-look surgery. Surgical outcomes were contrasted with pre surgical DWI and MRI result. Results: Of the 21 patients undergoing primary surgery, a cholesteatoma-related DWI high signal was identified in 95.45% of cases, having a specificity of 100% and a positive predictive value of 95.45%. The DWI showed a false negative case for cholesteatoma smaller than 3 mm. The DWI high signal related to residual cholesteatoma in the second-look surgery group was seen in 17 cases having a positive predictive value of 94.4%, a sensitivity of 94.4%, and a specificity of 100%. Due to a movement artifact, the DWI displayed a false negative case. Our study discovered no false positive or no true negative cases. Conclusions: This retrospective analysis concluded that diffusion-weighted MRI is an effective diagnostic method for primary cholesteatoma and for evaluating postoperative cases. | ||||
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