Robert Nash1, Phui Yee Wong1, Ali Kalan1, Ravi K Lingam2, Arvind Singh1. 1. Department of Otolaryngology, Head and Neck Surgery, Northwick Park Hospital & Central Middlesex Hospital, London Northwest Healthcare NHS Trust, Harrow, London HA1 3UJ, United Kingdom. 2. Department of Radiology, Northwick Park Hospital & Central Middlesex Hospital, London Northwest Healthcare NHS Trust, Harrow, London HA1 3UJ, United Kingdom. Electronic address: raviklingam@yahoo.co.uk.
Abstract
INTRODUCTION: There is a limited evidence base for the use of diffusion weighted MRI (DWMRI) in the assessment of post-operative cholesteatoma in children. This is important to address as this technique is particularly relevant in a paediatric setting. METHODS: We searched a prospectively collected database of patients undergoing DWMRI for the assessment of residual and recurrent cholesteatoma. Imaging findings were correlated with findings at revision surgery. 320 investigations were divided into paediatric and adult groups (90 in children, 230 in adults) and compared. RESULTS: Operative findings were available for 158 cases, of which 54 were children. The accuracy of DWMRI in children was 96.3%, and in adults was 88.5%. There were no statistically significant differences in the sensitivity, specificity, positive or negative predictive values between adults and children. DISCUSSION: An increasing number of patients are not undergoing confirmatory surgery after negative DWMRI scans. False negative results are commonly secondary to small foci of disease; false positives have several possible causes. Performing MRI on children can be challenging, but sedation may be helpful in younger children. CONCLUSION: The performance of diffusion weighted MRI is similar in paediatric and adult settings. This study suggests that DWMRI may be used in clinical practice in a similar way in children and adults.
INTRODUCTION: There is a limited evidence base for the use of diffusion weighted MRI (DWMRI) in the assessment of post-operative cholesteatoma in children. This is important to address as this technique is particularly relevant in a paediatric setting. METHODS: We searched a prospectively collected database of patients undergoing DWMRI for the assessment of residual and recurrent cholesteatoma. Imaging findings were correlated with findings at revision surgery. 320 investigations were divided into paediatric and adult groups (90 in children, 230 in adults) and compared. RESULTS: Operative findings were available for 158 cases, of which 54 were children. The accuracy of DWMRI in children was 96.3%, and in adults was 88.5%. There were no statistically significant differences in the sensitivity, specificity, positive or negative predictive values between adults and children. DISCUSSION: An increasing number of patients are not undergoing confirmatory surgery after negative DWMRI scans. False negative results are commonly secondary to small foci of disease; false positives have several possible causes. Performing MRI on children can be challenging, but sedation may be helpful in younger children. CONCLUSION: The performance of diffusion weighted MRI is similar in paediatric and adult settings. This study suggests that DWMRI may be used in clinical practice in a similar way in children and adults.
Authors: Richard G Kavanagh; Stephen Liddy; Anne G Carroll; Yvonne M Purcell; Anna E Smyth; S Guan Khoo; Graeme McNeill; Dermot E Malone; Ronan P Killeen Journal: Neuroradiol J Date: 2020-04-27
Authors: Felice D'Arco; Livja Mertiri; Pim de Graaf; Bert De Foer; Katarina S Popovič; Maria I Argyropoulou; Kshitij Mankad; Hervé J Brisse; Amy Juliano; Mariasavina Severino; Sofie Van Cauter; Mai-Lan Ho; Caroline D Robson; Ata Siddiqui; Steve Connor; Sotirios Bisdas Journal: Neuroradiology Date: 2022-04-23 Impact factor: 2.804
Authors: Victor J Kroon; Steven W Mes; Pepijn A Borggreven; Rick van de Langenberg; David R Colnot; Jasper J Quak Journal: Eur Arch Otorhinolaryngol Date: 2022-10-08 Impact factor: 3.236