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European Archives of Oto-Rhino-Laryngology

, Volume 269, Issue 3, pp 757–765 | Cite as

Predictive validity of MRI in detecting and following cholesteatoma

  • Milan Profant
  • Katarína Sláviková
  • Zuzana Kabátová
  • Peter Slezák
  • Iveta Waczulíková
Otology

Abstract

High recurrence rate of the middle ear cholesteatoma requires regular postoperative follow-up. This study evaluated data from the patients investigated with DW MRI to ascertain (1) the strength of the technique in detecting primary, and residual recurrent cholesteatoma, and (2) its accuracy in differentiating cholesteatoma from postoperative tissue changes. The diagnostic accuracy of two different DW imaging (EPI and non-EPI) techniques was evaluated. The data have been collected prospectively from 33 consecutive patients with either primary cholesteatoma, or with suspicious symptoms for potential cholesteatoma recurrence. The findings from non-EPI (HASTE) DW MR and EPI DW MR images were blindly compared with those obtained during a primary or secondary surgery. Preoperative non-EPI (HASTE) DWI pointed to a cholesteatoma in 25 out of 33 patients. In this subgroup, cholesteatoma were confirmed also by the surgery. In five cases, the non-EPI (HASTE) DWI did not show a cholesteatoma in the temporal bone, which agreed with the surgical findings. Three misclassifications were made by non-EPI (HASTE) DWI, all in the subgroup of patients indicated for primary surgery. The resulting pooled sensitivity of non-EPI (HASTE) DW imaging for diagnosing cholesteatoma in our study amounted to 96.15% (95% confidence interval (CI) 80.36–99.9), specificity was 71.43% (95% CI 29.04–96.33). Positive predictive value was 92.59% (95% CI 75.71–99.09) and negative predictive value 83.33% (95% CI 35.88–99.58). In conclusion, we recommend the non-EPI (HASTE) DW MRI as a valid method for diagnosing cholesteatoma and follow-up after cholesteatoma surgery.

Keywords

Otitis media chronica Cholesteatoma Primary surgery for cholesteatoma Second-look surgery CT Non-EPI (HASTE) DWI MRI 

Notes

Conflict of interest

This work was supported by the Slovak Research and Development Agency under the contract No. APVV-0148-10 and by the grant VEGA No. 1/0465/11.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Milan Profant
    • 1
  • Katarína Sláviková
    • 2
  • Zuzana Kabátová
    • 1
  • Peter Slezák
    • 3
  • Iveta Waczulíková
    • 4
  1. 1.Department of OtorhinolaryngologyUniversity Hospital BratislavaBratislavaSlovak Republic
  2. 2.Department of RadiologyUniversity Hospital BratislavaBratislavaSlovak Republic
  3. 3.Institute of Normal and Pathological PhysiologySlovak Academy of SciencesBratislavaSlovak Republic
  4. 4.Faculty of Mathematics, Physics and InformaticsComenius University BratislavaBratislavaSlovak Republic

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