From the Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.
From the Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
AJNR Am J Neuroradiol. 2022 Jul;43(7):1029-1035. doi: 10.3174/ajnr.A7538. Epub 2022 Jun 2.
Cholesteatoma is an aggressive disease that may lead to hearing impairment. This study aimed to compare the utility of high-resolution CT and TSE-DWI fusion images with that of T2WI and TSE-DWI fusion images in the localization of middle ear cholesteatoma.
Seventy-one patients with middle ear cholesteatoma were retrospectively recruited. High-resolution CT, T2WI with fat suppression, and TSE-DWI scans were obtained, and image fusion was performed using a 3D reconstruction postprocessing workstation to form CT-DWI and T2WI-DWI fusion images. The quality of the 2 fused images was subjectively evaluated using a 5-point Likert scale with the horizontal semicircular canal transverse position as the reference. Receiver operating characteristic analysis was performed, and the diagnostic efficacies of CT-DWI and T2WI-DWI fusion images in localizing middle ear cholesteatoma were calculated.
The overall quality of T2WI-DWI fusion images was slightly higher than that of CT-DWI fusion images (< .001), and the semicircular canal was slightly less clear on T2WI-DWI than on CT-DWI (< .001). No statistical difference was found in the diagnostic confidence between them. In the localization of middle ear cholesteatoma, the accuracy, sensitivity, and specificity of T2WI-DWI fusion images and CT-DWI fusion images were equivalent for involvement of the attic, tympanic cavity, mastoid antrum, and mastoid process, with no statistically significant differences.
T2WI-DWI fusion images could replace CT-DWI in the preoperative selection of surgical options for middle ear cholesteatoma.
胆脂瘤是一种侵袭性疾病，可导致听力损失。本研究旨在比较高分辨率 CT 和 TSE-DWI 融合图像与 T2WI 和 TSE-DWI 融合图像在中耳胆脂瘤定位中的应用价值。
回顾性分析 71 例中耳胆脂瘤患者，均行高分辨率 CT、T2WI 脂肪抑制及 TSE-DWI 扫描，利用 3D 后处理工作站行图像融合，分别形成 CT-DWI 和 T2WI-DWI 融合图像。以水平半规管横轴位为参照，采用 5 分制 Likert 量表对 2 种融合图像质量进行主观评价。绘制受试者工作特征曲线，计算 CT-DWI 和 T2WI-DWI 融合图像对中耳胆脂瘤定位的诊断效能。
T2WI-DWI 融合图像总体质量略优于 CT-DWI 融合图像（<0.001），但半规管显示略不如 CT-DWI 清晰（<0.001）。两者在诊断信心方面差异无统计学意义。在中耳胆脂瘤定位方面，T2WI-DWI 融合图像和 CT-DWI 融合图像对鼓室、鼓窦、乳突及乳突气房受累的准确率、敏感度及特异度相当，差异均无统计学意义。
T2WI-DWI 融合图像可替代 CT-DWI 用于术前选择中耳胆脂瘤的手术方案。
