Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2021, Vol. 35 ›› Issue (6): 65-69.doi: 10.6040/j.issn.1673-3770.0.2020.527

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Diffusion-weighted imaging for accurate diagnosis of congenital middle ear cholesteatoma and JOS staging

WAN Yining, ZHANG Dejun, FU Zeming, GUO Fang, GUO Yingyuan, GUAN Guofang   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, The Second Hospital of Jilin University, Changchun 130041, China
  • Published:2021-12-10

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Abstract: Objective To investigate the utility of diffusion-weighted imaging(DWI)for the accurate diagnosis of congenital middle ear cholesteatoma and the use of combining DWI with high-resolution computed tomography(HRCT)for the preoperative staging of congenital middle ear cholesteatoma. Methods Twelve patients with congenital middle ear cholesteatoma were selected to assess the diagnostic efficacy of DWI for congenital middle ear cholesteatoma. Preoperative staging was performed in accordance with the Japan Otology Society(JOS)staging criteria by performing both HRCT and DWI examinations. All patients underwent surgery and intraoperative staging. The findings of preoperative staging and intraoperative staging were compared to assess the consistency between them. Results DWI diagnosis was 100% accurate. HRCT combined with DWI for preoperative staging revealed congenital middle ear cholesteatoma of stage Ib in two cases, stage Ic in one case, stage II in eight cases, and stage III in one case. Intraoperative staging revealed the condition to be in stage Ib in one case, stage Ic in two cases, stage II in eight cases, and stage III in one case. The consistency between the two methods of staging was as high as 92%. Conclusion DWI has high sensitivity and specificity for detecting congenital middle ear cholesteatoma and can accurately diagnose the condition. At the same time, the combined use of HRCT and DWI can help establish precise staging before surgery, which can guide surgical treatment and indicate patient prognosis.

Key words: Diffusion weighted imaging, Congenital middle ear cholesteatoma, High-resolution computed tomography, Staging standard, Diagnosis, Levenson diagnostic criteria

CLC Number: 

  • R739.61
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