Apparent Diffusion Coefficients for Detection of Postoperative Middle Ear Cholesteatoma on Non-Echo-planar Diffusion-weighted Images
Apparent Diffusion Coefficients for Detection of Postoperative Middle Ear Cholesteatoma on Non-Echo-planar Diffusion-weighted Images
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DOI：
10.1148/radiol.13130065
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发表时间：
2013-11-01
期刊：
影响因子：
19.7
通讯作者：
Singh, Arvind
中科院分区：
文献类型：
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作者：
Lingam, Ravi K.;Khatri, Pushpa;Singh, Arvind
目的：确定术后中耳裂乳突瘤和非中耳裂乳突瘤组织在半傅立叶采集单次激发快速自旋回波扩散加权（DW）图像上的表观扩散系数（ADC）之间是否存在差异，并确定观察者之间的一致性，以预测术后中耳裂乳突瘤诊断的准确性。材料和方法：本研究纳入了因术后中耳炎再次探查手术前接受DW磁共振（MR）检查的患者。有72例患者发作，56例患者。采集DW MR图像，B值为0和1000 sec/mm（2），切片厚度为2 mm。两名观察员定性评估了是否存在中耳瘤的图像并记录了ADC。手术与组织学证实确立了中耳裂软组织异常的最终诊断。采用Mann-Whitney检验比较两组间ADC值的差异。采用ROC曲线分析、Logistic回归分析和观察者间一致性检验ADC值和可信区间对诊断中耳炎的影响。敏感性和特异性分别为0.91和0.88，使用五点置信度量表对术后中耳炎进行定性诊断。中耳瘤ADC值（中位数，707 x 10 - 6 mm 2/sec;四分位数范围，539-858 x 10 - 6 mm 2/sec; P < .001）显著低于非骨质疏松性中耳炎组织（中位数1849 × 1026 mm（2）/sec;四分位数间距1574-1982 3 10（-6）mm（2）/sec; P <0.001）。ADC阈值小于1300 × 10 - 6 mm 2/sec时，诊断术后中耳乳突瘤的准确性（ROC曲线下面积0.97）和观察者间一致性较好。结论：术后中耳乳突瘤的ADC值明显低于非中耳乳突瘤组织，诊断术后中耳乳突瘤的准确性较高。(C)RSNA，2013年
Purpose: To determine whether there is a difference between the apparent diffusion coefficients (ADCs) of postoperative middle ear cleft cholesteatoma and noncholesteatomatous tissue on half-Fourier acquisition single-shot turbo spin-echo diffusion-weighted (DW) images and to determine, with interobserver agreement, a predictive accuracy for diagnosis of postoperative middle ear cleft cholesteatoma.Materials and Methods: Patients who underwent DW magnetic resonance (MR) examination before repeat explorative surgery for postoperative cholesteatoma were included in this study. There were 72 patient episodes and 56 patients. DW MR images were acquired with b values 0 and 1000 sec/mm(2) and 2-mm section thicknesses. Two observers assessed images qualitatively for presence of cholesteatoma and recorded ADCs. Surgery with histologic confirmation established final diagnosis of abnormal middle ear cleft soft tissue. ADCs between cholesteatoma and noncholesteatomatous tissue were compared with Mann-Whitney test. Effects of ADCs and confidence intervals to indicate presence of cholesteatoma were examined by using receiver operating characteristic (ROC) curve analysis, logistic regression analysis, and interobserver agreement.Results: Forty-six patients had cholesteatoma and 25 patients did not; sensitivity and specificity were 0.91 and 0.88, respectively, for the qualitative diagnosis of postoperative cholesteatoma by using a five-point confidence scale. ADC of cholesteatoma (median, 707 x 10(-6) mm(2)/sec; interquartile range, 539-858 x 10(-6) mm(2)/sec; P < .001) was significantly lower than that of noncholesteatomatous tissue (median, 1849 x 1026 mm(2)/sec; interquartile range, 1574-1982 3 10(-6) mm(2)/sec; P < .001). There was good accuracy (area under the ROC curve, 0.97) and interobserver agreement for detecting postoperative cholesteatoma with ADC threshold less than 1300 x 10(-6) mm(2)/sec.Conclusion: The ADC value of postoperative middle ear cleft cholesteatoma is significantly lower than that of noncholesteatomatous tissue and has good accuracy for detecting cholesteatoma. (C) RSNA, 2013