HASTE diffusion-weighted MRI for the reliable detection of cholesteatoma

Diagn Interv Radiol. Mar-Apr 2012;18(2):153-8. doi: 10.4261/1305-3825.DIR.4246-11.3. Epub 2011 Sep 29.


Purpose: To assess the detection efficiency of Half-Fourier acquisition single-shot turbo spin-echo (HASTE) diffusion-weighted magnetic resonance imaging (MRI) for cholesteatoma.

Materials and methods: A total of 21 patients with suspected primary (n=16) or recurrent cholesteatoma (n=5) underwent MRI in a 1.5 Tesla scanner using an adapted protocol for cholesteatoma detection that included a coronal HASTE diffusion-weighted MRI sequence. The cholesteatoma diagnosis was based on evidence of a hyperintense lesion at b-1000 on diffusion-weighted images. The imaging findings were correlated with findings from surgery or clinical evaluations in all patients.

Results: HASTE diffusion-weighted MRI successfully detected 11 primary and 5 recurrent lesions out of 17 cholesteatomas (sensitivity, 94.1%). One primary cholesteatoma with a diameter of 4-5 mm was missed. MRI of patients without cholesteatoma were correctly interpreted as negative for cholesteatoma (specificity, 100%). The positive and negative predictive values for the HASTE diffusion-weighted MRI in detecting cholesteatoma were 100% and 80%, respectively.

Conclusion: HASTE diffusion-weighted MRI offers great promise for cholesteatoma screening. The addition of this sequence to the posterior fossa MRI protocol may preclude unnecessary cholesteatoma surgery.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cholesteatoma, Middle Ear / diagnosis*
  • Cholesteatoma, Middle Ear / pathology
  • Cholesteatoma, Middle Ear / surgery*
  • Cohort Studies
  • Diffusion Magnetic Resonance Imaging / methods*
  • Female
  • Humans
  • Image Processing, Computer-Assisted*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Otologic Surgical Procedures / methods
  • Prospective Studies
  • Recurrence
  • Reference Values
  • Reoperation / methods
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Young Adult