Diagnosis of recurrent cholesteatoma using diffusion weighted MRI

ObjectiveTo assess the role of diffusion weighted images (DWI) MRI in differentiating post mastoidectomy recurrent cholesteatoma from infected postoperative granulation tissue.Materials and methods13 patients who performed mastoidectomy for previous cholesteatoma that now presented with clinical and CT signs of recurrence were referred to perform non contrast MRI using T2 and DWI sequences in order to differentiate recurrent cholesteatoma from infected postoperative granulation tissue.Results8 patients showed MRI evidence of recurrent cholesteatoma, findings were confirmed intra-operative, -ve cases showed good response on medical treatment with regression of their clinical and radiological signs.ConclusionDWI MRI accurately differentiates recurrent cholesteatoma from infected post operative granulation tissue avoiding unnecessary second look operations.