Abstract:
BACKGROUND:Currently, there is only limited and contradictory evidence of the role of diffusion-weighted MRI (DW-MRI) in the management of children with cholesteatoma. OBJECTIVE:To provide surgically controlled data that may allow to replace second-look surgery by non-echoplanar DW-MRI in children. MATERIALS AND METHODS:Fifty-five children and adolescents with a median age of 8.6 years (2.2-17.7 years) underwent 61 preoperative half-Fourier acquisition single-shot turbo spin-echo (HASTE) DW-MRI of their petrous bone. Surgical interventions followed within 24 h (79%), within 5 months (20%) or at 18 months (1 case). RESULTS:Surgery detected a cholesteatoma or retraction pocket in 41 of 61 cases (67%). In 49 cases (80%), the MR result was confirmed by surgical findings. Two MR findings were false-positive and 10 false-negative (including cholesteatomas <4 mm). HASTE DW-MRI alone had a sensitivity of 76% and a specificity of 90%. The positive predictive value was 94%, the negative predictive value 64%. In combination with preoperative otoscopy, sensitivity was 90% and negative predictive value 82%. CONCLUSION:DW-MRI correctly detected the majority of lesions but could not reliably exclude small cholesteatomas and empty retraction pockets. We would therefore not generally recommend MR as a substitute for second-look surgery.
journal_name
Pediatr Radioljournal_title
Pediatric radiologyauthors
von Kalle T,Amrhein P,Koitschev Adoi
10.1007/s00247-015-3287-ysubject
Has Abstractpub_date
2015-07-01 00:00:00pages
1031-8issue
7eissn
0301-0449issn
1432-1998journal_volume
45pub_type
杂志文章abstract::A marked thoracic deformity associated with intrathoracic tracheal narrowing was seen in a 17-year-old with achondroplasia and dyspnea. The role of chest deformity and its evaluation by CT and MRI in achondroplastic patients with respiratory symptoms are considered. ...
journal_title:Pediatric radiology
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journal_title:Pediatric radiology
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更新日期:2013-03-01 00:00:00
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