Role of Non-Echo-Planar Diffusion Weighted MRI Imaging (DWI MRI) in Unsafe Chronic Otitis Media (CSOM): A Clinical Study at a Tertiary Care Center in Uttarakhand

Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5305-5311. doi: 10.1007/s12070-024-04967-3. Epub 2024 Aug 17.

Abstract

In course of evaluation of cholesteatoma, High resolution Computerized Tomography provides significant information regarding the extent of disease and associated bony erosion, if any but lags behind in differentiating soft tissue densities often associated with the disease. For this reason, Diffusion Weighted Magnetic Resonance Imaging has come to assume a significant role in the differential diagnosis of various soft tissue lesions found in chronic suppurative otitis media including cholesteatoma. The aim of the study was to evaluate the role of DWI Non-ECHO planar MRI in imaging of middle ear along with HRCT Scan of temporal bone in diagnosis of unsafe (squamous) CSOM. It was a hospital based descriptive cross-sectional study carried out over a period of 24 months at Government Doon Medical College, Dehradun, Uttarakhand. Thirty adult patients in the age group of 18-65 years with features suggestive of unsafe (squamous) CSOM were recruited. There was good correlation between DWI Non-ECHO Planar MRI images and histopathological findings however further studies with recruitment of large number of patients are required to establish the fact. It was concluded that DWI Non ECHO planar MRI plays a significant role in diagnosing cholesteatoma and should be utilized wherever possible for differential diagnosis of soft tissue lesions associated with chronic suppurative otitis media including cholesteatoma.

Keywords: Apparent diffusion coefficients; Cholesteatomas; DWI MRI; Diffusion weighted MRI; Recurrent cholesteatoma.