Comparison of MR imaging findings in paediatric and adult patients with acute mastoiditis and incidental intramastoid bright signal on T2-weighted images

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Saat , R , Mahmood , G , Laulajainen-Hongisto , A , Lempinen , L , Aarnisalo , A A , Jero , J & Markkola , A T O 2016 , ' Comparison of MR imaging findings in paediatric and adult patients with acute mastoiditis and incidental intramastoid bright signal on T2-weighted images ' , European Radiology , vol. 26 , no. 8 , pp. 2632-2639 . https://doi.org/10.1007/s00330-015-4113-5

Title: Comparison of MR imaging findings in paediatric and adult patients with acute mastoiditis and incidental intramastoid bright signal on T2-weighted images
Author: Saat, R.; Mahmood, G.; Laulajainen-Hongisto, A.; Lempinen, Laura; Aarnisalo, A. A.; Jero, J.; Markkola, Antti Thor Olavi
Contributor: University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Clinicum
University of Helsinki, Korva-, nenä- ja kurkkutautien klinikka
University of Helsinki, Clinicum
University of Helsinki, Korva-, nenä- ja kurkkutautien klinikka
University of Helsinki, Korva-, nenä- ja kurkkutautien klinikka
University of Helsinki, Clinicum
Date: 2016-08
Language: eng
Number of pages: 8
Belongs to series: European Radiology
ISSN: 0938-7994
URI: http://hdl.handle.net/10138/224106
Abstract: To compare MR imaging features in patients with incidental mastoid T2-hyperintensity with those of clinical acute mastoiditis, to ascertain characteristic differences between them. MR images of 35 adult and paediatric patients with clinical acute mastoiditis and 34 consecutive age-matched controls without relevant middle ear pathology and with incidental T2-hyperintensity that covered >= 50 % of the mastoid were retrospectively analysed with regard to signal, diffusion, and enhancement characteristics, and presence of complications. Incidental mastoid T2-hyperintensity that covered >= 50 % of the mastoid volume was found in 4.6 % of reviewed MR scans (n = 2341), and associated significantly (p <0.05) less with the involvement of the tympanic cavity (38 % vs. 74 %) and mastoid antrum (56 % vs. 80 %), hypointense-to-CSF signal intensity on T2 FSE (6 % vs. 86 %), intramastoid diffusion restriction (0 % vs. 62 %), intense intramastoid enhancement (0 % vs. 51 %), periosteal enhancement (3 % vs. 69 %), perimastoid dural enhancement 3 % vs. 43 %), bone destruction (0 % vs 49 %), intratemporal abscess or cholesteatoma (0 % vs. 24 %), labyrinth involvement (0 % vs. 14 %), and extracranial abscesses (0 % vs. 20 %). Hypointense-to-CSF signal intensity on T2WI, restricted diffusion, intense intramastoid enhancement among other MR imaging characteristics favoured an acute mastoiditis diagnosis over clinically non-relevant incidental mastoid pathology. Intramastoid T2-hyperintensity alone is not a reliable sign for acute mastoiditis. In acute mastoiditis, intramastoid T2-weighted signal intensity is usually hypointense to CSF. Diffusion restriction and intense intramastoid enhancement are absent in incidental mastoid effusion. An ADC value >= 1.72 x 10 (-3) mm (2) /s contradicts the AM diagnosis.
Subject: Mastoiditis
Otitis media
Middle ear
Temporal bone
Magnetic resonance imaging
ACUTE OTITIS-MEDIA
MIDDLE-EAR
CHILDREN
ABNORMALITIES
COMPLICATIONS
RADIOLOGY
RELEVANCE
CAVITY
3126 Surgery, anesthesiology, intensive care, radiology
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