Importance of diffusion weighted magnetic resonance imaging at differentiation of cholesteatoma and granulation tissue in patients with chronic suppurative otitis media

Yıl 2015, Cilt: 25 Sayı: 5, 225 - 265, 10.10.2015

Göksel Tuzcu Aytül Hande Yardımcı Önder Turna Reyyan Elif Göner Engin Acıoğlu

Öz

Objectives: This study aims to report the significance of echo-planar diffusion-weighted imaging EP-DWI in preoperative magnetic resonance imaging of patients with surgically corrected cholesteatoma and granulation tissue according to DWI and apparent diffusion coefficient ADC values. Patients and Methods: Ninety-one patients 52 males, 39 females; mean age 40.7±15.8 years; range 3 to 77 years who admitted to radiology clinic of our hospital between December 2009 and May 2011 with a pre-diagnosis of chronic otitis media with primary acquired cholesteatoma and assessed preoperatively in our clinic by ear magnetic resonance imaging and DWI were included in the study. Diffusion-weighted imaging results were compared with operative findings and pathology results. Patients were retrospectively evaluated using picture archiving and communication system. Diffusion-weighted imaging and ADC images were examined qualitatively and quantitatively. Results: Ninety-one patients suspected of cholesteatoma were operated. According to the results of operations, 50 patients had cholesteatoma and 41 patients had granulation tissue. The mean DWI values of patients with cholesteatoma were significantly higher than patients with granulation tissue p<0.05 . The mean ADC values of patients with cholesteatoma were significantly lower than patients with granulation tissue p<0.05 . The sensitivity and specificity of EP-DWI in detection of cholesteatoma were 97.6% and 92.0%, respectively. Conclusion: Echo-planar diffusion-weighted imaging by using ADC and DWI is a valuable tool with high sensitivity and specificity rates in detecting cholesteatoma particularly bigger than 5 mm and in differentiating them from other pathologies.

Anahtar Kelimeler

Apparent diffusion coefficient, cholesteatoma, echo-planar diffusion-weighted imaging, granulation tissue

Kronik süpüratif otitis medialı hastalarda kolesteatom ve granülasyon dokusu ayrımında difüzyon ağırlıklı manyetik rezonans görüntülemenin önemi

Öz

Amaç: Bu çalışmada kolesteatom ve granülasyon dokusu cerrahi ile düzeltilen hastaların ameliyat öncesi manyetik rezonans görüntülemelerinde eko-planar difüzyon ağırlıklı görüntüleme EP-DAG ’nin önemi DAG ve görünür difüzyon katsayısı GDK değerleri doğrultusunda sunuldu.Hastalar ve Yöntemler: Aralık 2009 - Mayıs 2011 tarihleri arasında hastanemizin radyoloji kliniğine primer kazanılmış kolesteatomlu kronik otitis media ön tanısı ile başvuran ve ameliyat öncesi kliniğimizde kulak manyetik rezonans görüntüleme ve DAG ile değerlendirilen 91 hasta 52 erkek, 39 kadın; ort. yaş 40.7±15.8 yıl; dağılım 3-77 yıl çalışmaya alındı. Difüzyon ağırlıklı görüntüleme sonuçları ameliyat bulguları ve patoloji sonuçları ile karşılaştırıldı. Hastalar görüntü arşivleme ve iletişim sistemi kullanılarak geriye dönük olarak değerlendirildi. Difüzyon ağırlıklı görüntüleme ve GDK görüntüleri niteliksel ve sayısal açıdan incelendi.Bulgular: Kolesteatom şüphesi bulunan 91 hasta ameliyat edildi. Ameliyat sonuçlarına göre, 50 hastada kolesteatom ve 41 hastada granülasyon dokusu vardı. Kolesteatomlu hastaların DAG değerleri granülasyon dokusu olan hastalara göre anlamlı olarak yüksekti p

Anahtar Kelimeler

Görünür difüzyon katsayısı, kolesteatom, eko-planar difüzyon ağırlıklı görüntüleme, granülasyon dokusu

Kaynakça

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