PT  - JOURNAL ARTICLE
AU  - Baráth, K.
AU  - Huber, A.M.
AU  - Stämpfli, P.
AU  - Varga, Z.
AU  - Kollias, S.
TI  - Neuroradiology of Cholesteatomas
AID  - 10.3174/ajnr.A2052
DP  - 2011 Feb 01
TA  - American Journal of Neuroradiology
PG  - 221--229
VI  - 32
IP  - 2
4099  - http://www.ajnr.org/content/32/2/221.short
4100  - http://www.ajnr.org/content/32/2/221.full
SO  - Am. J. Neuroradiol.2011 Feb 01; 32
AB  - SUMMARY: The relevant aspects of cholesteatomas are reviewed with the emphasis on their diagnosis by using cross-sectional imaging. The indications and limitations of CT and MR imaging and the use of novel MR imaging techniques in the diagnosis of cholesteatomas are described. HRCT of the temporal bone has an excellent spatial resolution, thus even small soft-tissue lesions can be accurately delineated (high sensitivity). However, CT has poor specificity (ie, soft-tissue structures cannot be differentiated). MR imaging with the conventional sequences (T1WI, T2WI, postcontrast T1WI) provides additional information for distinguishing different pathologic entities and for accurately diagnosing primary (nonsurgical) and residual/recurrent (surgical) cholesteatomas. Higher diagnostic specificity is achieved by introducing DW-EPI, delayed postcontrast imaging, DW-non-EPI, and DWI-PROPELLER techniques. Studies using DW-non-EPI and DWI-PROPELLER sequences show promising results related to improved diagnostic sensitivity and specificity for even small (<5 mm) cholesteatomas, thus allowing avoidance of second-look surgery in the future. DWIdiffusion-weighted imagingDW-EPIdiffusion-weighted echo-planar imagingDWI-PROPELLERdiffusion-weighted imaging with periodically rotated overlapping parallel lines with enhanced reconstructionDW-non-EPIdiffusion-weighted non-echo-planar imagingEACexternal auditory canalEACCexternal auditory canal cholesteatomaEPIecho-planar imagingFIESTAfast imaging employing steady-state acquisitionFLASHfast low-angle shotHRCThigh-resolution CTNPVnegative predictive valuePPVpositive predictive valueT1WIT1-weighted imagingT2WIT2- weighted imagingTMtympanic membrane