Tuzcu Göksel, Yardımcı Aytül Hande, Turna Önder, Göner Reyyan Elif, Acıoğlu Engin
Department of Radiology, Malatya State Hospital, 44090 Malatya, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2015;25(5):255-65. doi: 10.5606/kbbihtisas.2015.25675.
This study aims to report the significance of echo-planar diffusion-weighted imaging (EP-DWI) in preoperative magnetic resonance imaging of patients with surgically corrected cholesteatoma and granulation tissue according to DWI and apparent diffusion coefficient (ADC) values.
Ninety-one patients (52 males, 39 females; mean age 40.7±15.8 years; range 3 to 77 years) who admitted to radiology clinic of our hospital between December 2009 and May 2011 with a pre-diagnosis of chronic otitis media with primary acquired cholesteatoma and assessed preoperatively in our clinic by ear magnetic resonance imaging and DWI were included in the study. Diffusion-weighted imaging results were compared with operative findings and pathology results. Patients were retrospectively evaluated using picture archiving and communication system. Diffusion-weighted imaging and ADC images were examined qualitatively and quantitatively.
Ninety-one patients suspected of cholesteatoma were operated. According to the results of operations, 50 patients had cholesteatoma and 41 patients had granulation tissue. The mean DWI values of patients with cholesteatoma were significantly higher than patients with granulation tissue (p<0.05). The mean ADC values of patients with cholesteatoma were significantly lower than patients with granulation tissue (p<0.05). The sensitivity and specificity of EP-DWI in detection of cholesteatoma were 97.6% and 92.0%, respectively.
Echo-planar diffusion-weighted imaging by using ADC and DWI is a valuable tool with high sensitivity and specificity rates in detecting cholesteatoma particularly bigger than 5 mm and in differentiating them from other pathologies.
本研究旨在根据扩散加权成像（DWI）和表观扩散系数（ADC）值，报告回波平面扩散加权成像（EP-DWI）在手术矫正胆脂瘤和肉芽组织患者术前磁共振成像中的意义。
纳入2009年12月至2011年5月间因初步诊断为原发性后天性胆脂瘤型慢性中耳炎而入住我院放射科，并在我院门诊接受耳部磁共振成像和DWI术前评估的91例患者（男52例，女39例；平均年龄40.7±15.8岁；范围3至77岁）。将扩散加权成像结果与手术结果及病理结果进行比较。使用图像存档与通信系统对患者进行回顾性评估。对扩散加权成像和ADC图像进行定性和定量检查。
91例疑似胆脂瘤患者接受了手术。根据手术结果，50例患者患有胆脂瘤，41例患者患有肉芽组织。胆脂瘤患者的平均DWI值显著高于肉芽组织患者（p<0.05）。胆脂瘤患者的平均ADC值显著低于肉芽组织患者（p<0.05）。EP-DWI检测胆脂瘤的敏感性和特异性分别为97.6%和92.0%。
利用ADC和DWI的回波平面扩散加权成像在检测胆脂瘤尤其是大于5mm的胆脂瘤并将其与其他病变区分开来方面是一种具有高敏感性和特异性的有价值工具。
