Optimizing Cholesteatoma Assessment: Utilizing of Diffusion-Weighted Magnetic Resonance Imaging and Computed Tomography Imaging for Diagnostic Precision and Surgical Excellence

Background: Cholesteatoma is a sac-like growth inside the temporal bone that can cause bone disintegration and intracranial problems. CT is the preferred imaging method for diagnosis, but MRI is needed for better soft tissue resolution. Recurrent Cholesteatoma may require a second surgery for diagnosis. DW-MRI is a useful tool for studying Cholesteatoma.Aim of the work: The current study evaluated the diagnostic performance of diffusion weighted magnetic resonance imaging [DW-MRI] and computed tomography [CT] in Cholesteatoma and the usefulness of DW-MRI in identifying residual or early recurrence from post-operative alterations.Patients and Methods: A study was conducted at Al-Azhar University Hospital to assess patients with suspected Cholesteatoma. The study included 30 patients, both males and females, ranging in age from 15 to 60 years. Exclusion criteria included contraindications to MRI or CT examinations and recent middle ear surgery. The assessment of patients included a clinical examination and review of previous radiological examinations. CT imaging was performed using a multi-detector CT scanner, while 2-DW-MRI imaging was conducted using a 1.5 Tesla magnetic resonance scanner. Additional sequences were added to aid in anatomical localization.Results: This study found that DWI MRI had 84.6% sensitivity and 100% specificity, while CT had 52% sensitivity and 60% specificity. The accuracy values of DWI MRI and CT were 86.66% and 53.33%, respectively.Conclusion: Both DWI and CT can diagnose Cholesteatoma, however DWI MRI has a higher diagnostic rate than CT. Using both together delivers better results, accurate diagnosis, and better surgical guidance.