• Home
  • Practice Focus
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
    • How I Do It
    • TRIO Best Practices
  • Business of Medicine
    • Health Policy
    • Legal Matters
    • Practice Management
    • Tech Talk
    • AI
  • Literature Reviews
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Career
    • Medical Education
    • Professional Development
    • Resident Focus
  • ENT Perspectives
    • ENT Expressions
    • Everyday Ethics
    • From TRIO
    • The Great Debate
    • Letter From the Editor
    • Rx: Wellness
    • The Voice
    • Viewpoint
  • TRIO Resources
    • Triological Society
    • The Laryngoscope
    • Laryngoscope Investigative Otolaryngology
    • TRIO Combined Sections Meetings
    • COSM
    • Related Otolaryngology Events
  • Search

High-Resolution CT and Diffusion-Weighted MRI Combo Improves Pediatric Cholesteatoma Detection

by George T. Hashisaki, MD • February 7, 2011

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
Print-Friendly Version

Does the technique of fusing MRI images with high-resolution CT images improve the efficiency of detecting recurrent cholesteatoma in children, in particular for small cholesteatomas?

You Might Also Like

  • High-Resolution Microendoscopy Shows Promise for Intraoperative Head and Neck Squamous Cell Carcinoma Margin Detection
  • MRI, CT Imaging Beneficial for Pediatric Sensorineural Hearing Loss
  • T1W Imaging May Aid in Diagnosing Cholesteatomas
  • MRI, CT Beneficial for Pediatric Sensorineural Hearing Loss
Explore This Issue
February 2011

Background: Radiographic documentation of small recurrent cholesteatoma following pediatric middle ear/mastoid surgery or primary diagnosis of a small congenital cholesteatoma could provide benefit in the management decisions for these entities. Diffusion-weighted MRI techniques do not require IV gadolinium and have good ability to detect cholesteatoma as small as 3-5 mm, but with poor anatomic resolution. High-resolution CT scanning provides good anatomic localization, but the distinction between cholesteatoma and non-cholesteatoma soft tissue is often difficult. Fusing diffusion-weighted MRI scans with high-resolution CT may combine the benefits of both techniques, with fewer drawbacks.

Study design: Retrospective cohort study.

Setting: Tertiary care university hospital.

Synopsis: Ten patients, aged two to 17 years, with a suspicion of recurrent cholesteatoma, or congenital cholesteatoma underwent high-resolution CT scanning and MRI scanning. Neither anesthesia nor IV contrast media were given. The CT images and the diffusion-weighted MRI images were fused by coregistration using commercially available computer software. CT images alone were considered positive in four patients and confirmed at surgery in three of the four patients. Diffusion-weighted MRI images alone were considered positive in nine patients and confirmed positive in all nine patients. The one patient with a negative MRI was confirmed negative at surgery. Fusing the CT and MRI data led to the same degree of diagnostic accuracy as MRI alone, with the advantage of accurate anatomic location data confirmed at the time of surgery.

Bottom line: Fusion of high-resolution CT images and diffusion-weighted MRI images holds great promise for accurate diagnosis and localization of recurrent cholesteatoma or congenital cholesteatoma as small as 3 mm. The techniques do not require anesthesia, and IV contrast may be avoided. Additional data should be collected to confirm the diagnostic accuracy of this combination of radiographic studies.

Citation: Plouin-Gaudon I, Bossard D, Ayari-Khalfallah S, et al. Fusion of MRIs and CT scans for surgical treatment of cholesteatoma of the middle ear in children. Arch Otolaryngol Head Neck Surg. 2010;136(9):878-883.

—Reviewed by George T. Hashisaki, MD

Filed Under: Clinical, Literature Reviews, Otology/Neurotology Tagged With: cholesteatomas, clinical, CT, CT images, diagnosis, MRI, MRI imagesIssue: February 2011

You Might Also Like:

  • High-Resolution Microendoscopy Shows Promise for Intraoperative Head and Neck Squamous Cell Carcinoma Margin Detection
  • MRI, CT Imaging Beneficial for Pediatric Sensorineural Hearing Loss
  • T1W Imaging May Aid in Diagnosing Cholesteatomas
  • MRI, CT Beneficial for Pediatric Sensorineural Hearing Loss

The Triological SocietyENTtoday is a publication of The Triological Society.

Polls

Would you choose a concierge physician as your PCP?

View Results

Loading ... Loading ...
  • Polls Archive

Top Articles for Residents

  • Applications Open for Resident Members of ENTtoday Edit Board
  • How To Provide Helpful Feedback To Residents
  • Call for Resident Bowl Questions
  • New Standardized Otolaryngology Curriculum Launching July 1 Should Be Valuable Resource For Physicians Around The World
  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Keeping Watch for Skin Cancers on the Head and Neck

    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

    • Otolaryngologists Are Still Debating the Effectiveness of Tongue Tie Treatment

    • Clinical Grading System for Reinke’s Edema

    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?

    • Otolaryngologists Are Still Debating the Effectiveness of Tongue Tie Treatment

    • Complications for When Physicians Change a Maiden Name

    • Excitement Around Gene Therapy for Hearing Restoration
    • “Small” Acts of Kindness
    • How To: Endoscopic Total Maxillectomy Without Facial Skin Incision
    • Science Communities Must Speak Out When Policies Threaten Health and Safety
    • Observation Most Cost-Effective in Addressing AECRS in Absence of Bacterial Infection

Follow Us

  • Contact Us
  • About Us
  • Advertise
  • The Triological Society
  • The Laryngoscope
  • Laryngoscope Investigative Otolaryngology
  • Privacy Policy
  • Terms of Use
  • Cookies

Wiley

Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1559-4939