RADIOLOGICAL DIAGNOSIS AND MONITORING OF CHOLESTEATOMA
Alizada E.E.1,2, Serova N.S.1
1 - I.M. Sechenov First Moscow State Medical University of the Ministry (Sechenov University).
2 - National Medical Research Center for Otorhinolaryngology of the FMBA. Moscow, Russia.
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urpose. To assess the available methods for radiological diagnostics and monitoring of cholesteatoma.
Materials and methods. The study involved data from 110 patients with cholesteatoma at the Federal State Budgetary Institution "The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia" of the Federal Medical and Biological Agency of Russia and at the I.M. Sechenov First Moscow State Medical University (Sechenov University). All patients underwent pre- and post-operative magnetic resonance imaging (MRI) in non-EPI DWI mode and multispiral computed tomography (MSCT).
Results. At the preoperative stage, among the 110 patients (100%) who underwent MSCT scans and MRI in non-EPI DWI mode, right-sided cholesteatoma was detected in 54 cases (n=54; 49.1%), left-sided cholesteatoma in 49 cases (n=49; 44.5%), and bilateral cholesteatoma in 7 cases (n=7; 6.4%). Postoperative MRI revealed 15 cases (n=15; 13.6%) of cholesteatoma recurrence, and remaining cholesteatoma matrix cells were found in 7 patients (n=7; 6.4%). Consequently, the sensitivity (Se) of MRI in non-EPI DWI mode for detecting recurrent and residual cholesteatoma was 95.5%, with a specificity (Sp) of 96.6%. In comparison, these values for MSCT scans were 86.4% and 81.8%, respectively.
Discussion. In postoperative monitoring, distinguishing cholesteatoma from other pathological processes poses significant challenges during MSCT scans. Postoperative inflammatory changes make it impossible to assess the condition of the temporal bones for recurrence or residual cholesteatoma. The clinical presentation often carries subjective characteristics, making it challenging to evaluate reliably. Our study results demonstrate the potential of detecting a visual sign in the form of diffusion restriction when there are indications of recurrent or residual cholesteatoma, using the non-echo-planar diffusion-weighted imaging sequence.
Conclusion. Incorporating the non-echoplanar diffusion weighted imaging technique in temporal bone MRI proves invaluable in identifying visual indicators of cholesteatoma, even at its initial stages. This significantly influences the surgical treatment approach.
Keywords cholesteatoma, MSCT, MRI, non-EPI DWI, radiology.
Corresponding author: Alizada Elshad, 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. Radiological diagnosis and monitoring of cholesteatoma. REJR 2023; 13(2):38-49. DOI: 10.21569/2222-7415-2023-13-2-38-49.
Received: 20.09.23 Accepted: 31.10.23