Cholesteatoma Clinical Trial
Official title:
Usefulness of Non EPI-DWI-MRI / CT 3D Static Co-registration Prior to Surgery of Cholesteatomas
Cholesteatoma is a destructive and expanding pathologic condition consisting of keratin pearl
arising from a squamous epithelium in the middle ear and/or mastoid process. Evolution
consists in a destruction of the ossicles as well as their possible spread through the base
of the skull into the brain. Surgical treatment is required to prevent infectious or
functional complications. A recurrence after surgery occurs in approximately 10% of patients
and rarely affects initial site. Surgical treatment is the only care option for recurrent
cholesteatoma. Various locations such as surgical approach cavity, mastoid, hypotympanum are
seen. Temporal bone CT is performed prior to surgery for added information on bone erosions
especially of ossicules, tegmen tympani, facial nerve canal of internal ear. Due high
anatomical resolution and complex anatomy, temporal bone CT is usually displayed with
Magnetic Resonance Imaging (MRI) in operating room to help surgical guidance .
Imaging especially using MRI is the cornerstone for diagnosis in asymptomatic patients. Since
2006, non echo planar imaging (EPI) Diffusion weighted imaging (DWI) Magnetic resonance
imaging (MRI) (sequences has shown high accuracy to depict recurrent cholesteatoma. If EPI
sequences had a high rate of diffeomorphic atefacts whereas non EPI sequences using either
HAlf-Fourier acquisition Single-shot Turbo spin-Echo (HASTE) or Fast-spin-echo demonstrates
less magnetic susceptibility artifacts. Multimodality fusion between NonEPI-DWI-MRI and
computerized tomography (CT) is a rational promising tool to rise the performance for
cholesteatomas delineation. The performances of NonEPI-DWI-MRI in assessing lesion spread and
volume are still unknown and needs further investigations. The aim of the study is to assess
the DWI-MRI/CT fusion feasibility, reproducibility and the accuracy prior to surgery
propectively compared to surgical findings.
n/a
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