Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria.
Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria.
J Neuroimaging. 2022 Jan;32(1):120-126. doi: 10.1111/jon.12919. Epub 2021 Aug 16.
Diffusion-weighted imaging(DWI) in MRI has been developed as an important tool for the detection of cholesteatoma. Various DWI sequences are available. This study aims to evaluate the importance of the observer's reliance level for the detection of cholesteatoma.
Forty patients meeting the following criteria were included in the study: (1) chronic otitis media, (2) preoperative MRI including various DWI sequences, and (3) middle-ear surgery. The MRI protocol contained the following sequences: (1) axial and (2) coronal echoplanar imaging (EPI) readout-segmented (RESOLVE) DWI with Trace acquisition and (3) coronal non-EPI half-Fourier acquired single-shot turbo spin-echo (HASTE) DWI. Cholesteatoma diagnosis was based on standard diagnostic criteria for cholesteatoma with DWI. Additionally, the radiologists were asked to grade personal reliance on their diagnosis using a Likert-type scale from 1 = very insecure to 5 = very secure.
Axial and coronal RESOLVE DWI showed a sensitivity of 77.3% and a specificity of 72.2%, respectively. The mean reliance was 3.9 for axial and 3.8 for coronal images. HASTE DWI had a sensitivity/specificity of 81.8%/66.7% with the highest reliance of all evaluated sequences (4.4). Cases with a reliance level of 5 showed a sensitivity/specificity of 100% in all sequences. A reliance level of 5 was given in the axial and coronal RESOLVE DWI in 32.5% of cases and in the HASTE DWI in 57.5%.
The evaluated DWI sequences showed comparable results. The reliance level significantly improved the predictor of cholesteatoma disease with MRI techniques.
磁共振成像（MRI）中的弥散加权成像（DWI）已成为检测胆脂瘤的重要工具。有多种 DWI 序列可供选择。本研究旨在评估观察者的依赖程度对胆脂瘤检测的重要性。
本研究纳入了符合以下标准的 40 名患者：（1）慢性中耳炎，（2）术前 MRI 包括各种 DWI 序列，（3）中耳手术。MRI 方案包括以下序列：（1）轴位和（2）冠状面回波平面成像（EPI）读出分段（RESOLVE）DWI，采用轨迹采集（Trace acquisition）和（3）冠状面非 EPI 半傅里叶采集单次激发涡轮自旋回波（HASTE）DWI。胆脂瘤的诊断基于 DWI 的胆脂瘤标准诊断标准。此外，要求放射科医生使用李克特量表（从 1 = 非常不可靠到 5 = 非常可靠）对他们的诊断个人依赖程度进行评分。
轴位和冠状位 RESOLVE DWI 的灵敏度分别为 77.3%和 72.2%。平均依赖程度为轴位 3.9，冠状位 3.8。HASTE DWI 的灵敏度/特异性分别为 81.8%/66.7%，是所有评估序列中依赖程度最高的（4.4）。依赖程度为 5 的病例在所有序列中的灵敏度/特异性均为 100%。在轴向和冠状 RESOLVE DWI 中，有 32.5%的病例和在 HASTE DWI 中，有 57.5%的病例依赖程度为 5。
评估的 DWI 序列显示出相当的结果。依赖程度显著提高了 MRI 技术对胆脂瘤疾病的预测能力。
