Department of Odontostomatological and Maxillo-Facial Sciences, Umberto I Hospital, University Sapienza, Via di Grottarossa, 00135, Rome, Italy.
NESMOS, Department of Neuroradiology, S. Andrea Hospital, University Sapienza, Rome, Italy.
Radiol Med. 2020 Jan;125(1):75-79. doi: 10.1007/s11547-019-01085-x. Epub 2019 Sep 20.
The aim of the present prospective study was to verify the specificity of non-EPI DWI-MRI in patients operated for middle ear CHO who showed positivity at imaging performed 6 to 9 months after surgery and underwent second-look surgery.
All patients underwent 1.5-T non-EPI DWI-MRI 6 to 9 months after surgery: those showing a hyper-intense signal in the middle ear underwent a revision surgery, whilst the others are still under radiological follow-up and were not considered in this study. Two radiologists independently evaluated the images; both placed a standard region of interest inside the brightest part of the observed signal alteration on coronal HASTE-DWI images. The mean and maximum signal intensity values on the DWI images were recorded for each patient. A signal intensity ratio was calculated using the inferior temporal cortex and the background noise.
One hundred and forty-three subjects were evaluated for a total of 210 ears. In 116 (170 ears), a normal non-EPI DWI-MRI was found with exclusion from this study, whilst twenty-seven subjects showed a high signal lesion inside the middle ear and underwent revision surgery. According to the ROC analysis, SI, SIRT and SIRTmax showed the best statistical values in comparison with the other parameters.
Residual/recurrent CHO can be accurately detected using quantitative evaluation of non-EPI DWI-MRI.
本前瞻性研究的目的是验证非 EPI DWI-MRI 在术后 6 至 9 个月影像学检查呈阳性并接受二次探查手术的中耳胆固醇肉芽肿（CHO）患者中的特异性。
所有患者均在术后 6 至 9 个月行 1.5-T 非 EPI DWI-MRI 检查：中耳出现高信号的患者行修正手术，而其他患者仍在进行影像学随访，未纳入本研究。两位放射科医生独立评估图像；均在冠状 HASTE-DWI 图像上观察到信号改变最亮部位内部放置标准感兴趣区。记录每位患者 DWI 图像上的平均和最大信号强度值。使用颞下皮质和背景噪声计算信号强度比。
共评估了 143 例患者，总计 210 耳。在 116 例（170 耳）中，行非 EPI DWI-MRI 检查未见异常，排除本研究，而 27 例患者中耳内出现高信号病变并接受修正手术。根据 ROC 分析，SI、SIRT 和 SIRTmax 与其他参数相比具有最佳的统计学值。
定量评估非 EPI DWI-MRI 可准确检测残余/复发性 CHO。
