Growth and Late Detection of Post-Operative Cholesteatoma on Long Term Follow-Up With Diffusion Weighted Magnetic Resonance Imaging (DWI MRI): A Retrospective Analysis From a Single UK Centre.
Otol Neurotol
; 40(5): 638-644, 2019 06.
Article
in En
| MEDLINE
| ID: mdl-31083089
ABSTRACT
OBJECTIVE:
To evaluate the growth rate and late detection of residual cholesteatoma on long-term follow-up with diffusion weighted magnetic resonance imaging (DWI MRI) in clinically stable ears following definitive surgery, in order to define surveillance imaging protocols. STUDYDESIGN:
Retrospective case review.SETTING:
Tertiary referral center. PATIENTS Patients who underwent DWI MRI at our institution between February 2007 and May 2013 for postoperative cholesteatoma follow-up. INTERVENTION Non-echo planar imaging (non-EPI) Half-Fourier Acquisition Single-shot Turbo spin Echo (HASTE) DWI MRI. MAIN OUTCOMEMEASURES:
Intervals between the definitive surgery and the first and subsequent DWI MRI, the maximum coronal dimension of the lesion on DWI and length of follow-up.RESULTS:
The study evaluated 152 postoperative DWI studies performed for 88 patients. In 12 cases, DWI was initially negative but became positive on repeat imaging after a mean interval of 3.8 years from the initial cholesteatoma surgery (median 3.7 years, range 1.6-7.9). Of these, 3/12 had more than one negative/indeterminate DWI before disease was eventually detected on imaging; in this subgroup, the mean interval between surgery and positive DWI was 3.2 years (median 2.6 years, range 2.3-4.2). 39 DWI positive foci with serial imaging demonstrated a mean growth rate of 4âmm/year (median 2âmm, range 0-18).CONCLUSIONS:
After negative initial DWI, it is proposed that interval imaging should be considered for a minimum of 5 years in stable ears following definitive cholesteatoma surgery. In view of the marked variability in growth rate, an additional interval scan between 2 and 3 years postoperatively is indicated.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cholesteatoma, Middle Ear
/
Diffusion Magnetic Resonance Imaging
Type of study:
Diagnostic_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Otol Neurotol
Journal subject:
NEUROLOGIA
/
OTORRINOLARINGOLOGIA
Year:
2019
Document type:
Article