MULTIMODAL IMAGING ASSESSMENT IN CHOLESTEATOMA: CT AND NON-EPI DWI MRI COMPARATIVE ANALYSIS

urpose.To compare the diagnostic accuracy of multislice computed tomography (MSCT) and non-EPI diffusion-weighted imaging (DWI) MRI in the preoperative assessment and postoperative monitoring of cholesteatoma with a focus on residual and recurrent disease.Materials and methods.We conducted a retrospective analysis of 110 patients with cholesteatoma who underwent both preoperative and postoperative imaging, including non-EPI DWI MRI and MSCT.Diagnostic performance was evaluated based on surgical and follow-up findings.Results.Preoperative evaluation of 110 patients using both MSCT and non-EPI DWI MRI identified right-sided cholesteatoma in 54 cases (49.1%), left-sided in 49 (44.5%), and bilateral involvement in 7 (6.4%).Postoperative MRI detected recurrent cholesteatoma in 15 patients (13.6%) and residual matrix in 7 (6.4%).Non-EPI DWI MRI demonstrated superior diagnostic accuracy (sensitivity 95.5%, specificity 96.6%) compared to MSCT (86.4% and 81.8%, respectively) for detecting recurrent and residual disease.Discussion.While MSCT remains a standard tool for anatomical assessment, its utility in postoperative monitoring is limited due to difficulties in distinguishing cholesteatoma from inflammatory changes.Non-EPI DWI MRI, by contrast, provides superior soft-tissue contrast and reliably detects restricted diffusion -a key marker of cholesteatoma -even in early-stage or residual disease. Conclusion.Non-EPI DWI MRI should be the preferred imaging modality for postoperative cholesteatoma surveillance, offering high sensitivity and specificity that directly influence clinical decision-making.