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PT  - JOURNAL ARTICLE
AU  - Lehmann, P.
AU  - Saliou, G.
AU  - Brochart, C.
AU  - Page, C.
AU  - Deschepper, B.
AU  - Vallée, J.N.
AU  - Deramond, H.
TI  - 3T MR Imaging of Postoperative Recurrent Middle Ear Cholesteatomas: Value of Periodically Rotated Overlapping Parallel Lines with Enhanced Reconstruction Diffusion-Weighted MR Imaging
AID  - 10.3174/ajnr.A1352
DP  - 2009 Feb 01
TA  - American Journal of Neuroradiology
PG  - 423--427
VI  - 30
IP  - 2
4099  - http://www.ajnr.org/content/30/2/423.short
4100  - http://www.ajnr.org/content/30/2/423.full
SO  - Am. J. Neuroradiol.2009 Feb 01; 30
AB  - BACKGROUND AND PURPOSE: MR diagnostic of postoperative recurrent cholesteatomas is difficult. Our purpose was to compare multishot fast spin-echo periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) diffusion-weighted MR imaging (DWI) with array spatial sensitivity encoding technique (ASSET) single-shot echo-planar DWI and late postgadolinium T1-weighted MR imaging for the detection of postoperative recurrent middle ear cholesteatomas with a 3T imaging unit.MATERIALS AND METHODS: Thirty-five patients with suggested postoperative recurrent middle ear cholesteatoma underwent 3T MR imaging with PROPELLER DWI, ASSET echo-planar DWI, and late postgadolinium T1-weighted MR imaging. Three radiologists (2 seniors, 1 fellow) analyzed unlabeled images for visualization of recurrence. Interobserver and intraobserver agreement was assessed by using the Cohen κ statistic test. Sensitivity, specificity, and predictive value were assessed for the 3 observers.RESULTS: Nineteen recurrent cholesteatomas were diagnosed. PROPELLER interobserver agreement was very good (1, 0.89, 0.89) among the 3 observers. Intraobserver agreement between PROPELLER and T1-weighted imaging was very good to moderate (0.88, 0.57, 0.58). PROPELLER DWI provided less interobserver variability than other sequences, and the best sensitivity, specificity, and predictive value.CONCLUSIONS: On a 3T imaging unit, multishot fast spin-echo PROPELLER DWI allows an easier detection of postoperative recurrent middle ear cholesteatoma than T1-weighted imaging by reducing artifacts and by its better contrast. DWI with PROPELLER is diagnostically robust and accurate.