Saturday 3 March 2012

Mastoiditis: An over diagnosis on MRI

T2 high signal suggestive of fluid in mastoid air cells on MRI is often reported as Mastoiditis by radiologist.
In studies conducted on patients with radiological mastoiditis, the 82% of patients did not show any evidence of clinical mastoiditis. So MRI is not an effective screening modality for mastoiditis. The diagnosis of "mastoiditis" is not based on the MRI findings alone.
In the majority of cases, fluid in the mastoid air cells, is not due to an infection, but rather due to Eustachian tube dysfunction and is more appropriately called a "mastoid effusion." So in such scenario better not to use excessively alarming terms such as "mastoiditis" particularly if someone has no real mastoiditis related symptoms clinically.
Just mention the finding of T2 high signal intensity of fluid in mastoid air cells in the report with stating that significance to be given in proper clinical context.

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