Value of Echo-Planar Diffusion-Weighted Magnetic Resonance Imaging for Detecting Tympanomastoid Cholesteatoma.

OBJECTIVE The aim of this study was to evaluate the diagnostic accuracy of echo-planar diffusion-weighted magnetic resonance imaging (EP-DWI) and high-resolution computed tomography (HRCT) in the detection and localization of cholesteatoma. MATERIALS AND METHODS Fifty-four patients were prospectively included in this study. Patients with suspected primary or residual cholesteatoma were evaluated by EP-DWI and HRCT before tympanomastoid surgery. Radiological findings were correlated with intraoperative findings. RESULTS EP-DWI and HRCT accurately predicted the presence or absence of cholesteatoma in 49 of 54 (90.7%) and 37 of 54 (68.5%) patients, respectively. The sensitivity, specificity, and positive and negative predictive values of EP-DWI were 88.4%, 92.8%, 92%, and 89.6%, respectively. However, sensitivity, specificity, and positive and negative predictive values of HRCT were 69%, 67.8%, 66.6%, and 73.07%, respectively. CONCLUSION This study demonstrates that EP-DWI is more reliable in predicting the presence and localization of cholesteatoma compared with HRCT, before tympanomastoid surgery.