Performance of Non-EPI DW MRI for Pediatric Cholesteatoma Follow-Up.
Otolaryngol Head Neck Surg
; 170(1): 221-229, 2024 Jan.
Article
in En
| MEDLINE
| ID: mdl-37313857
ABSTRACT
OBJECTIVE:
To evaluate the accuracy, sensitivity, and specificity of nonecho planar (non-EPI) diffusion-weighted (DW) magnetic resonance imaging (MRI) to detect residual cholesteatoma in children. STUDYDESIGN:
Retrospective study.SETTING:
Tertiary comprehensive hospital.METHODS:
Children operated on for a first-stage cholesteatoma procedure from 2010 to 2019 were included. MRIs were performed with non-EPI DW sequences. Initial reports were collected, indicating the presence or absence of hyperintensity suggestive of cholesteatoma. Three hundred twenty-three MRIs were correlated with the subsequent surgery (66%) or year-later MRI (21%), or were considered accurate if performed 5 years or more after the last surgery (13%). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each imaging procedure for the detection of cholesteatoma were calculated.RESULTS:
Two hundred twenty-four children with mean age of 9 ± 4 years old presented with cholesteatoma. MRIs were performed 27 ± 24 months after surgery. Residual cholesteatoma was diagnosed in 35%. The sensitivity, specificity, PPV, and NPV of MRI were 62%, 86%, 74%, and 78%, respectively. Accuracy, sensitivity, and specificity increased significantly over time (multivariate analysis). The mean delay after last surgery was of 30 ± 2.0 months for accurate MRI (true positive or negative) versus 17 ± 2.0 months for nonaccurate (false positive or negative) MRIs (p < .001).CONCLUSION:
However, long the delay after the last surgery, the sensitivity of non-EPI diffusion sequence MRI in children has limitations for the detection of residual cholesteatoma. Surveillance for residual cholesteatoma should incorporate findings at primary surgery, surgeon experience, a low threshold for second-look procedures, and routine imaging.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cholesteatoma, Middle Ear
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Child
/
Child, preschool
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Humans
Language:
En
Journal:
Otolaryngol Head Neck Surg
Journal subject:
OTORRINOLARINGOLOGIA
Year:
2024
Document type:
Article
Affiliation country: