Kronik süpüratif otitis medialı hastalarda kolesteatom ve granülasyon dokusu ayrımında difüzyon ağırlıklı manyetik rezonans görüntülemenin önemi

OBJECTIVES: This study aims to report the significance of echo-planar diffusion-weighted imaging (EP-DWI) in preoperative magnetic resonance imaging of patients with surgically corrected cholesteatoma and granulation tissue according to DWI and apparent diffusion coefficient (ADC) values. PATIENTS AND METHODS: Ninety-one patients (52 males, 39 females; mean age 40.7±15.8 years; range 3 to 77 years) who admitted to radiology clinic of our hospital between December 2009 and May 2011 with a pre-diagnosis of chronic otitis media with primary acquired cholesteatoma and assessed preoperatively in our clinic by ear magnetic resonance imaging and DWI were included in the study. Diffusion-weighted imaging results were compared with operative findings and pathology results. Patients were retrospectively evaluated using picture archiving and communication system. Diffusion-weighted imaging and ADC images were examined qualitatively and quantitatively. RESULTS: Ninety-one patients suspected of cholesteatoma were operated. According to the results of operations, 50 patients had cholesteatoma and 41 patients had granulation tissue. The mean DWI values of patients with cholesteatoma were significantly higher than patients with granulation tissue (p<0.05). The mean ADC values of patients with cholesteatoma were significantly lower than patients with granulation tissue (p<0.05). The sensitivity and specificity of EP-DWI in detection of cholesteatoma were 97.6% and 92.0%, respectively. CONCLUSION: Echo-planar diffusion-weighted imaging by using ADC and DWI is a valuable tool with high sensitivity and specificity rates in detecting cholesteatoma particularly bigger than 5 mm and in differentiating them from other pathologies.