Value of T1-weighted Magnetic Resonance Imaging in Cholesteatoma Detection
Value of T1-weighted Magnetic Resonance Imaging in Cholesteatoma Detection
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DOI：
10.1097/mao.0000000000001558
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发表时间：
2017-12-01
影响因子：
2.1
通讯作者：
Homma, Akihiro
中科院分区：
文献类型：
--
作者：
Fukuda, Atsushi;Morita, Shinya;Homma, Akihiro
目的：揭示 T1 加权 (T1W) 成像对诊断胆脂瘤磁共振 (MR) 成像的有用性。研究设计：回顾性病例回顾。设置：三级转诊中心。患者：53 名疑似胆脂瘤患者（57 只耳朵）并接受治疗（6-82 岁）。干预：术前 MR 成像，包括非回声平面（非 EP）扩散加权(DW) 和 T1W 成像。主要结果指标：主要结果指标包括单独使用非 EP DW 成像（标准 1）和非 EP DW 成像结合 T1W 成像（标准 2）检测胆脂瘤的诊断准确性之间的比较。通过比较磁共振成像与手术结果来评估每个病例的诊断准确性。次要结果指标包括胆脂瘤和非胆脂瘤显示高非 EP DW 信号的病例之间显示高 T1W 信号的比率的比较。 结果：根据标准 1 的敏感性、特异性和准确性分别为 93.5、63.6 和 87.7%，根据标准 2 的敏感性、特异性和准确性分别为 89.1、100 和 91.2%。在 43 例显示高非 EP DW 信号的胆脂瘤病例中，只有 2 例显示高 T1W 信号（5%）。另一方面，所有四例显示高非 EP DW 信号的非胆脂瘤病例均显示高 T1W 信号 (100%)，并且这些比率显着不同 (p< 0.001)。结论：我们的结果表明，T1W 成像可能有助于排除诊断性非 EP DW MR 成像胆脂瘤的假阳性病例。与单独的非 EP DW 成像相比，非 EP DW 和 T1W 成像的组合可以提高特异性和准确性。
Objective: To reveal the usefulness of T1-weighted (T1W) imaging on diagnostic magnetic resonance (MR) imaging for cholesteatoma.Study Design: A retrospective case review.Setting: Tertiary referral center.Patients: Fifty-three patients (57 ears) suspected to have cholesteatomas and treated (6-82 yr of age).Intervention: Preoperative MR imaging, including non-echo planar (non-EP) diffusion-weighted (DW) and T1W imaging.Main Outcome Measures: Primary outcome measures included the comparison between the diagnostic accuracy for the detection of cholesteatomas using non-EP DW imaging alone (criterion 1) and non-EP DW imaging along with T1W imaging (criterion 2). Diagnostic accuracy was evaluated in each case by comparing MR imaging with surgical findings. Secondary outcome measures included the comparison of the rates of cases showing a high T1W signal between cholesteatomas and noncholesteatomas which showed a high non-EP DW signal.Results: The sensitivity, specificity, and accuracy according to criterion 1 were 93.5, 63.6, and 87.7% and those according to criterion 2 were 89.1, 100, and 91.2%, respectively. Of 43 cholesteatoma cases indicating a high non-EP DW signal, only 2 cases showed a high T1W signal (5%). On the other hand, all four noncholesteatoma cases indicating high non-EP DW signal showed a high T1W signal (100%), and these rates were significantly different (p< 0.001).Conclusion: Our results suggest that T1W imaging may aid in the exclusion of false-positive cases on diagnostic non-EP DW MR imaging for cholesteatomas. A combination of nonEP DW and T1W imaging may improve the specificity and accuracy compared with non-EP DW imaging alone.