Authors: Dr. R.L. Balavaitheeswar (Post Graduate, Radio-Diagnosis) Email id:[email protected]
Phone no:8124289716
Dr. Elamparidhi (Assistant professor, Radio-Diagnosis)
Dr. Umamageshwari (Professor and HOD, Radio-Diagnosis)
Sri ManakulaVinayagar Medical College and hospital, Madagadipet, Pondicherry.

Aims and objectives

To discuss the role of diffusion-weighted magnetic resonance imaging in differentiating granulation tissue and cholesteatoma using histopathological findings as a reference standard.

Materials and methods:

This study was a hospital-based Cross-sectional studyconducted in Department of Radio- Diagnosis,

In a total of 30 patients, diffusion sequence in MRI and their findings werecorrelated with post- operative histopathological findings during theperiod from October 2020 to October 2021 at Sri Manakula Vinayagar Medical College,Puducherry.

Diffusion weighted magnetic imaging studies are performed on 1.5 Tesla PHILIPS whole body MR systems using standard imaging head coil.


The mean age of presentation was found to be around 44 years of age with malepredominance. The most common presentation was mucopurulent discharge and conductive hearing loss. The sensitivity, specificity, PPV and NPV ofDWI was found to be 100% in diagnosing



HRCT gives better information preoperatively about the surgical approach. But its ability to differentiate CSOM from cholesteatoma is very poor. But DWI sequence in MR imaging is a simple tool which will accurately differentiate cholesteatoma from CSOM with the help of restriction.

Clinical relevance/Take home points:

In preoperative cases of chronic suppurative otitis media and cholesteatoma high resolution

computed tomography will describe the extent of thedisease with the surgical approach with details of erosion of bony structures whereas diffusion-weighted magnetic resonance

sequence was able to differentiate cholesteatoma from other common inflammatory middle ear disease.