Non-echoplanar diffusion-weighted magnetic resonance imaging (non-EPI-DWMRI) for depicting middle-ear cholesteatoma has a sensitivity as well as specificity at around 90%. It is the accumulated keratin, which results in a high-intensity signal. The detection limit is 3 mm. When applying non-EPI-DWMRI as part of post-operative follow-up, first scan is recommended around one year post-operatively followed by annual scans, until a possible recidive is expected to have reached the detection limit. In children, a closer follow-up is suggested, as paediatric cholesteatomas are more aggressive.
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