Non-EPI DWI MRI capabilities in diagnosis and monitoring of
a patient with cholesteatoma
Alizada E.E.1,2, Serova N.S.1, Korobkin A.S.2, Oganesyan Z.S.1
1 - I.M. Sechenov First Moscow State Medical University of the Ministry (Sechenov University). Moscow, Russia.
2 - FSBI «The National Medical Research Center for Otorhinolaryngology of the FMBA of Russia». Moscow, Russia.
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urpose. This study aims to demonstrate the high informative value of non-echoplanar diffusion-weighted magnetic resonance imaging (non-EPI DWI MRI) in diagnosing and monitoring cholesteatoma.
Material and methods. The clinical case presented involves a patient with chronic purulent otitis media on both sides, experiencing ear and periauricular pain, hearing impairment, and dizziness. The patient underwent comprehensive radiological diagnostics, including multi-slice computer tomography (MSCT) and non-EPI DWI MRI of the temporal bones at pre- and postoperative stages for cholesteatoma diagnosis and monitoring.
Results. Preoperative MSCT and MRI revealed bone structure destruction and signs of cholesteatoma. MSCT identified a large cavity filled with soft tissue, while non-EPI DWI MRI detected limited diffusion in the temporal bones. As a result of the operation, the patient had a cholesteatoma removed. Postoperatively, non-EPI DWI MRI revealed recurrent cholesteatoma, confirmed by histological examination, whereas MSCT did not indicate recurrence.
Discussion. Non-echoplanar diffusion-weighted sequence is a highly informative and artifact-resistant method in diffusion-weighted MRI. It proves essential in visualizing recurrent cholesteatoma, especially in cases with significant soft tissue in the middle ear cavity, where interpretation is challenging with other radiological methods like MSCT. In this case, non-EPI DWI MRI significantly improved diagnostic efficiency for cholesteatoma in both pre- and postoperative periods, complementing MSCT findings of temporal bone destruction, crucial for determining surgical strategies.
Conclusion. Non-EPI DWI MRI is invaluable in diagnosing and monitoring cholesteatoma, offering precise information on lesion localization and extent. It aids in confirming the diagnosis and guiding appropriate patient management strategies.
Keywords: cholesteatoma, petrous part of the temporal bone, MRI, MSCT, non-EPI DWI, diagnostic imaging.
Corresponding author: Alizada E.E., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Alizada E.E., Serova N.S., Korobkin A.S., Oganesyan Z.S. Non-EPI DWI MRI capabilities in diagnosis and monitoring of а patient with cholesteatoma. REJR 2023; 13(3):144-153. DOI: 10.21569/2222-7415-2023-13-3-144-153.
Received: 28.06.23 Accepted: 08.08.23