Diffusion-weighted magnetic resonance imaging with echo-planar and non-echo-planar (PROPELLER) techniques in the clinical evaluation of cholesteatoma

Abstract

Background: Diffusion-weighted magnetic resonance imaging (DWI) is an alternative to second-look surgery for the detection of cholesteatoma. Purpose: To assess the utility of DWI with echo-planar (EPI-DWI) and non-echo-planar (PROPELLER) sequences for the diagnosis of primary and recurrent cholesteatoma. Materials and methods: A prospective study of 33 ears, 21 with previous cholesteatoma surgery. Twelve patients were asymptomatic, with 4 showing signs suggestive of cholesteatoma in previous CT scans. The MRI protocol was: axial and coronal T1-weighted and T2-weighted imaging, and diffusion-weighted sequences by both EPI-DWI and PROPELLER techniques. The results were correlated with the clinical examination and subsequent surgical findings. Ten patients undergoing ear surgery for other reasons were included as negative controls.