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- Title
Rolul examenului imagistic în chirurgia otitelor medii supurate cronice.
- Authors
Maniu, Alma Aurelia; Stamate, Mirela; Ujvary, Peter; Blebea, Cristina; Necula, Violeta
- Abstract
High-resolution CT is the method of choice for imaging of the middle ear, particularly in cholesteatoma patients. In patients with recurrent cholesteatoma, high-resolution CT can show the extent of tumor tissue in relation to the ossicles, the labyrinthine structures, the epitympanic space, and the mastoid process. Osseous destructions are also reliably depicted. The diagnosis is based on the disclosure of a non-dependent, homogenous soft tissue mass with a focal area of bone destruction. However, if a soft-tissue mass in the middle ear is seen on high-resolution CT, the diagnosis of the mass is not very accurate, because cholesteatoma, mucoid secretion, granulation tissue, fibrous tissue, and cholesterol granuloma cannot be differentiated from one another on high-resolution CT. Magnetic Resonance Imaging (MRI) using standard T1- and T2-weighted sequences shows tissues better than high-resolution CT. Therefore, in some cases, MRI plays an important complementary role to high-resolution CT in the preoperative diagnostic workup. However, MRI with standard T1- and T2-weighted pulse sequences frequently fails to allow the differentiation of cholesteatoma from other soft tissues or mucoid secretions, particularly in patients who have undergone middle ear surgery. Recent studies of diffusion-weighted MRI show that it is sensitive to cholesteatoma. High signal intensity on a diffusion weighted sequence and a soft-tissue mass seen on conventional MRI sequences have a positive predictive value of 100% for cholesteatoma. This paper presents the advantages and disadvantages of using different imaging examination methods in chronic otitis media, exemplified with clinical cases.
- Publication
ORL.ro, 2019, Issue 42, p42
- ISSN
2067-6530
- Publication type
Article