Role of Non-Echoplanar Diffusion-Weighted Imaging and 3D FIESTA Magnetic Resonance Imaging Sequences in Addition to High-Resolution Computed Tomography Temporal Bone for Assessment and Prediction of the Outcome in Chronic Suppurative Otitis Media with Cho

Abstract

Background: Chronic suppurative otitis media (CSOM) with cholesteatoma is a persistent and potentially destructive ear condition. Non-echoplanar diffusion-weighted imaging (DWI) and 3D FIESTA (Fast Imaging Employing Steady-state Acquisition) magnetic resonance imaging (MRI) sequences have shown promise for enhanced diagnostic accuracy. This study examines the role of these imaging modalities alongside high- resolution computed tomography (HRCT) of the temporal bone in assessing CSOM with cholesteatoma and predicting patient outcomes. Methods: In this retrospective study, 50 patients with confirmed CSOM and cholesteatoma were assessed using HRCT, DWI, and 3D FIESTA MRI. Parameters including extent of cholesteatoma, presence of complications, and surgical findings were analyzed. Statistical associations between imaging findings and clinical outcomes were evaluated using chi-square and T-tests. Results: DWI and 3D FIESTA MRI provided enhanced visualization of cholesteatoma extent and identified high-risk features compared to HRCT alone. Patients with extensive cholesteatoma visualized on MRI sequences demonstrated poorer surgical outcomes (p < 0.05). The combined use of HRCT and MRI sequences showed higher sensitivity (92%) and specificity (88%) in detecting residual disease. Conclusion: Adding non-echoplanar DWI and 3D FIESTA MRI sequences to HRCT improves the assessment of cholesteatoma in CSOM, aiding in treatment planning and predicting outcomes. Implementing these modalities may significantly benefit clinical practice by reducing recurrence rates.