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Abstract

BACK GROUND : Cholesteatoma is non-neoplastic destructive lesion .MRI including diffusion weighted imaging (DWI) is helpful, since high content of keratin is associated with restricted diffusion. AIM OF STUDY: To determine the value of DWMRI and apparent diffusion coefficient (ADC) value in diagnosis of temporal bone cholesteatoma . PATIENTS AND METHOD : A prospective study conducted 33 patients with clinical suspicious of cholestatoma  using 1.5tesla  MRI scanner ,DWI with bvalue 1000 sec/ mm2.ADC was reconstructed and mean value measured  in mm2/sec for each lesion .Enhancing image obtained  after intravenous contrast administration  with early and delay images in suspected recurrent cases . RESULT: DWI  accurately detect 22 of 25 cholesteatoma lesions (sensitivity = 88% and specificity = 100%).Positive predictive value and negative predictive value were 100%  and76.9% respectively with accuracy rate 91.4%.  ADC value revealed  (0.469 x10-3  to 0.823 x10-3 mm2/sec) for restricted lesions  with  mean value ( 0.653 x10-3 ± 0.09092 SD mm2 /sec)which is significantly difference from non restricted lesions(P value  less than 0.001) .T1W  post contrast  images also give high accuracy  in diagnosis  of cholesteatoma 23 from 25 cases (sensitivity =92.59 %, specificity = 100). CONCLUSION: MRDWI give high accuracy in detection of cholestatoma in patient with chronic ear discharge.  

DOI

10.52573/ipmj.2021.174080

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