Diffusion-weighted magnetic resonance imaging in the management of cholesteatoma

Eur Arch Otorhinolaryngol. 2010 Feb;267(2):181-5. doi: 10.1007/s00405-009-1023-7. Epub 2009 Jul 4.


Diffusion-weighted (DW) MRI has recently increasingly gained popularity in the diagnosis of post-operative cholesteatoma. The aim of this study is to prospectively evaluate the usefulness of echo-planar imaging (EPI) for the diagnosis of residual cholesteatoma. Fifty patients underwent DW-EPI before surgery. Fifteen patients had a scan before their first surgery and 35 patients underwent neuroimaging prior to their second look surgery. In the first preoperative group of 15 patients, DW-EPI confirmed cholesteatoma in all the patients. In the post-operative group DW-EPI identified or excluded cholesteatoma correctly in 29 out of 35 patients. Our study has demonstrated a sensitivity of 83% and specificity of 82% of DW-EPI for the diagnosis of residual cholesteatoma. DW-EPI can be a value imaging modality and may help the surgeon in selecting patients for revision surgery.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Cholesteatoma / diagnosis*
  • Cholesteatoma / surgery
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Otologic Surgical Procedures / methods*
  • Reproducibility of Results
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult