Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California 94305-5739, USA.
Laryngoscope. 2013 May;123(5):1247-50. doi: 10.1002/lary.23759. Epub 2012 Sep 28.
OBJECTIVES/HYPOTHESIS: To describe the accuracy of non-echo-planar diffusion-weighted magnetic resonance imaging (DW MRI) in identifying middle ear cholesteatoma.
A meta-analysis of the published literature.
A systematic review of the literature was performed to identify studies in which patients suspected of having middle ear cholesteatoma underwent DW MRI scans prior to surgery. A meta-analysis of the included studies was performed.
Ten published articles (342 patients) met inclusion criteria. Cholesteatoma was confirmed in 234 patients, of which 204 were detected by DW MRI (true positives) and 30 were not (false negatives). One hundred eight patients did not have cholesteatoma on surgical examination, and of these 100 were correctly identified by MRI (true negatives) whereas eight were not (false positives). The overall sensitivity of DW MRI in detecting cholesteatoma was 0.94 (confidence interval, 0.80-0.98) and specificity 0.94 (confidence interval, 0.85-0.98). DW MRI sequences could not reliably detect cholesteatomas under 3 mm in size.
Non-echo-planar DW MRI is highly sensitive and specific in identifying middle ear cholesteatoma. DW MRI may help to stratify patients into groups of who would benefit from early second-look surgery and those who could be closely observed.
2a.
目的/假设：描述非平面回波扩散加权磁共振成像（DW MRI）在识别中耳胆脂瘤中的准确性。
对已发表文献的荟萃分析。
对疑似患有中耳胆脂瘤的患者在手术前进行 DW MRI 扫描的研究进行系统回顾。对纳入的研究进行荟萃分析。
符合纳入标准的有 10 篇已发表的文章（342 例患者）。胆脂瘤在 234 例患者中得到证实，其中 204 例经 DW MRI 检测（真阳性），30 例未检测（假阴性）。108 例患者在手术检查中未发现胆脂瘤，其中 100 例经 MRI 正确识别（真阴性），而 8 例未识别（假阳性）。DW MRI 检测胆脂瘤的总体敏感性为 0.94（置信区间，0.80-0.98），特异性为 0.94（置信区间，0.85-0.98）。DW MRI 序列无法可靠地检测到 3 毫米以下的胆脂瘤。
非平面回波 DW MRI 在识别中耳胆脂瘤方面具有高度的敏感性和特异性。DW MRI 可能有助于将患者分层为需要早期二次手术的获益组和可以密切观察的组。
2a。
