| Fusion of MRIs and CT scans for surgical treatment of cholesteatoma of the middle ear in children. | |
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MedLine Citation:
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PMID: 20855680 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the efficiency of diffusion-weighted magnetic resonance imaging (MRI) and high-resolution computed tomographic (CT) scan coregistration in predicting and adequately locating primary or recurrent cholesteatoma in children. DESIGN: Prospective study. SETTING: Tertiary care university hospital. PATIENTS: Ten patients aged 2 to 17 years (mean age, 8.5 years) with cholesteatoma of the middle ear, some of which were previously treated, were included for follow-up with systematic CT scanning and MRI between 2007 and 2008. INTERVENTIONS: Computed tomographic scanning was performed on a Siemens Somaton 128 (0.5/0.2-mm slices reformatted in 0.5/0.3-mm images). Fine cuts were obtained parallel and perpendicular to the lateral semicircular canal in each ear (100 × 100-mm field of view). Magnetic resonance imaging was undertaken on a Siemens Avanto 1.5T unit, with a protocol adapted for young children. Diffusion-weighted imaging was acquired using a single-shot turbo spin-echo mode. To allow for diagnosis and localization of the cholesteatoma, CT and diffusion-weighted MRIs were fused for each case. RESULTS: In 10 children, fusion technique allowed for correct diagnosis and precise localization (hypotympanum, epitympanum, mastoid recess, and attical space) as confirmed by subsequent standard surgery (positive predictive value, 100%). In 3 cases, the surgical approach was adequately determined from the fusion results. Lesion sizes on the CT-MRI fusion corresponded with perioperative findings. CONCLUSIONS: Recent developments in imaging techniques have made diffusion-weighted MRI more effective for detecting recurrent cholesteatoma. The major drawback of this technique, however, has been its poor anatomical and spatial discrimination. Fusion imaging using high-resolution CT and diffusion-weighted MRI appears to be a promising technique for both the diagnosis and precise localization of cholesteatomas. It provides useful information for surgical planning and, furthermore, is easy to use in pediatric cases. |
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Authors:
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Isabelle Plouin-Gaudon; Denis Bossard; Sonia Ayari-Khalfallah; Patrick Froehlich |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Archives of otolaryngology--head & neck surgery Volume: 136 ISSN: 1538-361X ISO Abbreviation: Arch. Otolaryngol. Head Neck Surg. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-21 Completed Date: 2010-10-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8603209 Medline TA: Arch Otolaryngol Head Neck Surg Country: United States |
Other Details:
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Languages: eng Pagination: 878-83 Citation Subset: AIM; IM |
Affiliation:
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Department of Pediatric Otolaryngology and Head and Neck Surgery, Centre Hospitalier de Valence, Valence, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Child Child, Preschool Cholesteatoma, Middle Ear / congenital, diagnosis*, surgery Diffusion Magnetic Resonance Imaging* Female Humans Image Processing, Computer-Assisted Male Recurrence Tomography, X-Ray Computed* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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