常规MRI及DWI诊断中耳表皮样瘤

Conventional MRI and DWI in the diagnosis of middle ear cholesteatoma

目的探讨常规MRI及DWI诊断表皮样瘤型中耳炎的价值。方法对21例临床疑诊表皮样瘤型中耳炎患者行术前常规MR检查,其中20例加行DWI,并将影像学诊断与手术、病理结果对比。结果常规MR检查23只患耳,其中18只符合表皮样瘤诊断标准,3只影像表现不典型;手术及病理均证实为表皮样瘤,另有1只假阳性及1只假阴性;在加行DWI的22只患耳中,20只呈明显高信号,诊断为表皮样瘤;1只呈低信号,考虑为炎症,均与手术病理结果一致;另1只伪影明显。常规MRI诊断表皮样瘤型中耳炎的敏感度、特异度分别为86.36%(19/22)、50.00%(1/2),而DWI的敏感度、特异度分别为95.24%(20/21)、100%(1/1)。结论联合应用常规MRI和DWI有利于准确诊断并定位表皮样瘤病灶。

Objective To assess the value of conventional MRI and DWI in the diagnosis of middle ear cholesteatoma.Methods Preoperative conventional MR scan was performed in 21 patients with clinically suspected cholesteatoma,while additional DWI was performed in 20 patients.The imaging findings were compared with the results of surgery and pathology.Results Among the 23 ears on conventional MRI,18 accorded with the diagnostic standards,3 had untypical menifestations.All 23 ears were confirmed as cholesteatoma,including 1 false positive and 1 false negative.Among 22 ears examined with DWI,20 ears showed high signal intensity of cholesteatoma,while 1 showed low signal was considered as inflammation.They were all accorded with the Results of surgery and pathology.Obvious artifact was observed on DWI in 1 case.The sensitivity and specificity of conventional MRI was 86.36%（19/22） and 50.00%（1/2）,while of DWI was 95.24%（20/21） and 100%（1/1）,respectively.Conclusion Combining of DWI and conventional MRI is helpful to diagnosing and locating middle ear cholesteatoma.