分段读出回波平面弥散加权成像在胆脂瘤检测中的应用：与手术验证的相关性。
Readout-Segmented Echo-Planar DWI for the Detection of Cholesteatomas: Correlation with Surgical Validation.
机构信息
From the Departments of Otorhinolaryngology (N.F., V.H.S., D.D., J.S., H.R.).
From the Departments of Otorhinolaryngology (N.F., V.H.S., D.D., J.S., H.R.)
出版信息
AJNR Am J Neuroradiol. 2019 Jun;40(6):1055-1059. doi: 10.3174/ajnr.A6079. Epub 2019 May 23.
BACKGROUND AND PURPOSE
MR imaging has become an important tool for the detection of cholesteatomas of the middle ear. Various diffusion-weighted imaging sequences are available and have shown promising results. This study aimed to evaluate readout-segmented echo-planar DWI for the detection of cholesteatoma and compare the results with surgical validation.
MATERIALS AND METHODS
Fifty patients with chronic otitis media (24 females and 26 males; range, 12-76 years of age; mean age, 41 years) who underwent MR imaging before an operation of the middle ear (1-169 days) were included. The MR imaging protocol consisted of axial and coronal readout-segmented echo-planar DWI with b-values of 0 and 1000 s/mm and 3-mm slice thickness. The readout-segmented echo-planar diffusion-weighted images were fused with standard T2-weighted sequences for better anatomic assignment. The results of the MR imaging evaluation were correlated with the results from the operation.
RESULTS
Readout-segmented echo-planar DWI detected 22 of the 25 cases of surgically proved cholesteatoma. It has an accuracy of 92% (95% confidence interval, 80.8%-97.8%), a sensitivity of 88%, a specificity of 96%, a positive predictive value of 96%, and a negative predictive value of 89%. In 1 case, a positive finding for cholesteatoma with readout-segmented echo-planar DWI could not be proved by histology, and in 3 cases, histology yielded a cholesteatoma that was not detected with MR imaging.
CONCLUSIONS
Readout-segmented echo-planar DWI is a promising and reliable MR imaging sequence for the detection and exclusion of cholesteatoma.
背景与目的
磁共振成像已成为中耳胆脂瘤检测的重要工具。现已有多种扩散加权成像序列，并已取得有前景的结果。本研究旨在评估回波平面读出分割弥散加权成像（readout-segmented echo-planar DWI）对胆脂瘤的检测，并与手术验证结果进行比较。
材料与方法
本研究纳入了 50 例慢性中耳炎患者（24 名女性，26 名男性；年龄 12-76 岁，平均年龄 41 岁），这些患者均在中耳手术前（1-169 天）进行了磁共振成像检查。磁共振成像方案包括轴位和冠状位回波平面读出分割弥散加权成像，b 值分别为 0 和 1000 s/mm，层厚 3mm。读出分割 echo-planar 弥散加权图像与标准 T2 加权序列融合，以更好地进行解剖学定位。将磁共振成像评估结果与手术结果进行相关性分析。
结果
回波平面读出分割弥散加权成像检测到 25 例手术证实的胆脂瘤中的 22 例。其准确率为 92%（95%置信区间，80.8%-97.8%），灵敏度为 88%，特异性为 96%，阳性预测值为 96%，阴性预测值为 89%。在 1 例中，回波平面读出分割弥散加权成像的阳性胆脂瘤发现结果无法通过组织学证实，而在 3 例中，组织学发现了磁共振成像未检测到的胆脂瘤。
结论
回波平面读出分割弥散加权成像序列是一种有前途且可靠的磁共振成像序列，可用于检测和排除胆脂瘤。
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