ArticleClinical neuroradiology2021
Detection of Coalescent Acute Mastoiditis on MRI in Comparison with CT.
Article in Clinical neuroradiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 16 citations in OpenAlex.
- Critical infections in the head and neck: A pictorial review of acute presentations and complications.The neuroradiology journal · 2024Review
- Emergency radiologic approach to mastoid air cell fluid.Emergency radiology · 2021Article
- Differences in mastoid and middle-ear cavity opacification in CT between intensive care patients and patients with acute mastoiditis requiring surgical treatment.European journal of radiology open · 2021Article
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCurrent imaging standard for acute mastoiditis (AM) is contrast-enhanced computed tomography (CT), revealing inflammation-induced bone destruction, whereas magnetic resonance imaging (MRI) outperforms CT in detecting intracranial infection. Our aim was to compare the diagnostic performance of MRI with CT in detecting coalescent AM and see to which extent MRI alone would suffice to diagnose or rule out this condition.
methodsThe MR images of 32 patients with AM were retrospectively analyzed. Bone destruction was evaluated from T2 turbo spin echo (TSE) and T1 Gd magnetization-prepared rapid acquisition with gradient echo (MPRAGE) images. Intramastoid enhancement and diffusion restriction were evaluated subjectively and intramastoid apparent diffusion coefficient (ADC) values were measured. The MRI findings were compared with contrast-enhanced CT findings of the same patients within 48 h of the MR scan.
resultsDepending on the anatomical subsite, MRI detected definite bone defects with a sensitivity of 100% and a specificity of 54-82%. Exception was the inner cortical table where sensitivity was only 14% and specificity was 76%. Sensitivity for general coalescent mastoiditis remained 100% due to multiple coexisting lesions. The absence of intense enhancement and non-restricted diffusion had a high negative predictive value for coalescent mastoiditis: an intramastoid ADC above 1.2 × 10
conclusionThe MRI did not miss coalescent mastoiditis but was inferior to CT in direct estimation of bone defects. When enhancement and diffusion characteristics are also considered, MRI enables dividing patients into low, intermediate and high-risk categories with respect to coalescent mastoiditis, where only the intermediate risk group is likely to benefit from additional CT.
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