ORIGINAL ARTICLE Fr ORL- 2008; 94: 366 Contribution of MRI to diagnosis of residual cholesteatoma

Objective: To determine the value of diffusion-weighted Magnetic Resonance Imagingcombined with a late post-gadolinium T1-weighted sequence for the detection of residual cholesteatoma in patients operated by closed tym-panoplasty. Materials and methods: Sixty one patients with suspicious partial or complete opacity in the middle ear on com-puted tomography were examined by MRI (CISS, diffusion-weighted, early and late T1-weighted sequences), before second-look surgery. Radiological findings were compared to surgical findings. Results: Twenty two of the 24 residual cholesteatomas were detected by MRI (sensitivity: 96%, negative predictive value: 94%) and the lesions not visualized measured less than 3 mm. Conclusion: In the presence of a suspicious opacity of the middle ear on computed tomography, the combination of diffusion-weighted MRI and a late post-gadolinium T1-weighted sequence appears to reliably detect residual cholesteatoma in patients operated by closed tympanoplasty. (Fr ORL- 2008; 94: 366-374