Comparison of different DWI techniques.

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Comparison of different DWI techniques. Comparison of different DWI techniques. A, EPI DWI acquired in a patient undergoing evaluation for possible demyelinating disease. Abnormal DWI signal intensity in the right temporal bone (arrow) prompted further evaluation for cholesteatoma. The abnormal DWI signal intensity is clearly visible due to the large size of the lesion, but there are artifacts from the skull base. B, SS TSE (HASTE) DWI sequences obtained in a patient with obscured visual examination due to postoperative changes. Increased diffusion signal intensity is seen in the right middle ear and mastoid defect (arrow), with cholesteatoma confirmed at surgery. C, Multishot TSE DWI (BLADE) image in a patient with otoscopic examination obscured by cartilaginous reconstruction shows increased DWI signal intensity (arrow) in the left epitympanum, with cholesteatoma confirmed at surgery. D, The multishot TSE DWI has the additional advantage of generating images in a coronal plane, which can be especially useful when erosion of the tegmen tympani and/or intracranial extension is suspected. Arrow indicates increased DWI in the left epitympanum. Fig. 1B was reproduced with permission from Ear, Nose & Throat Journal (Schwartz KM, Lane JI, Neff BA, et al. Diffusion-weighted imaging for cholesteatoma evaluation. 2010;89:E14-19).32 K.M. Schwartz et al. AJNR Am J Neuroradiol 2011;32:430-436 ©2011 by American Society of Neuroradiology