Non-echoplanar diffusion weighted imaging in the detection of post-operative middle ear cholesteatoma: navigating beyond the pitfalls to find the pearl
| Autor: | Robert Nash, Ravi Lingam, Ali Kalan, Anooj Majithia, Arvind Kumar Singh |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
medicine.medical_specialty lcsh:R895-920 Pictorial Review DWI 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine otorhinolaryngologic diseases medicine Middle Ear Cholesteatoma Image acquisition Radiology Nuclear Medicine and imaging Post operative Cholesteatoma 030223 otorhinolaryngology Neuroradiology business.industry Diffusion weighted imaging medicine.disease Diffusion-Weighted Magnetic Resonance Imaging Radiological weapon Radiology Pitfalls business MRI Diffusion MRI |
| Zdroj: | Insights into Imaging, Vol 7, Iss 5, Pp 669-678 (2016) Insights into Imaging |
| ISSN: | 1869-4101 |
| DOI: | 10.1007/s13244-016-0516-3 |
| Popis: | Non-echoplanar diffusion weighted magnetic resonance imaging (DWI) has established itself as the modality of choice in detecting and localising post-operative middle ear cleft cholesteatoma. Despite its good diagnostic performance, there are recognised pitfalls in its radiological interpretation which both the radiologist and otologist should be aware of. Our article highlights the various pitfalls and provides guidance for improving radiological interpretation and navigating beyond many of the pitfalls. It is recommended radiological practice to interpret the diffusion weighted images together with the ADC map and supplement with the corresponding T1 weighted and T2 weighted images, all of which can contribute to and enhance lesion localisation and characterisation. ADC values are also helpful in improving specificity and confidence levels. Given the limitation in sensitivity in detecting small cholesteatoma less than 3 mm, serial monitoring with DWI over time is recommended to allow any small residual cholesteatoma pearls to grow and become large enough to be detected on DWI. Optimising image acquisition and discussing at a joint clinico-radiological meeting both foster good radiological interpretation to navigate beyond the pitfalls and ultimately good patient care. • Non-echoplanar DWI is the imaging of choice in detecting post-operative cholesteatoma. • There are recognised pitfalls which may hinder accurate radiological interpretation. • Interpret with the ADC map /values and T1W and T2W images. • Serial DWI monitoring is of value in detection and characterisation. • Optimising image acquisition and discussing at clinico-radiological meetings enhance radiological interpretation. |
| Databáze: | OpenAIRE |
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