目的：分析磁共振成像的DWI、计算机断层扫描技术（CT）对慢性中耳乳突炎患者的诊断价值。方法：选取2019年2月至2022年7月楚雄州人民医院88例慢性中耳乳突炎患者，术前均接受CT、MRI检查。比较CT、MRI对慢性中耳乳突炎胆脂瘤的检出情况。分析慢性中耳乳突炎患者的CT及MRI表现。以手术病理检查结果为金标准，比较MRI-DWI、CT对慢性中耳乳突炎患者胆脂瘤病变的灵敏度、特异度及准确度。分析MRI-DWI、CT与手术病理检查结果间的一致性。结果：CT检查灵敏度为51.7%，特异度为83.1%、准确度为72.7%，CT 与手术病理检查结果间的一致性检验 Kappa =0.360，P=0.001，Kappa值有统计学差异，但一致性低。MRI-DWI检查灵敏度62.1%，特异度89.8%，准确度为80.7%，MRI-DWI与手术病理检查结果间的一致性检验 Kappa =0.543，P<0.001，Kappa值有统计学差异，一致性中等。结论 ：MRI-DWI在慢性中耳乳突炎的胆脂瘤诊断价值高于CT，CT提供了更好的空间定位，二者是互补技术，二者的结合应用对胆脂瘤和听骨链状态能有较好的术前评估，对术者选择较好术式及入路有一定的指导价值。
Objective：To analyze the diagnostic value of magnetic resonance imaging DWI and computed tomography (CT) in patients with chronic middle ear mastoiditis. Ｍethod:A total of 88 patients with chronic craniocerebral ear mastoiditis in Chuxiong People's Hospital from February 2019 to July 2022 were selected, and all of them received CT and MRI examination before surgery. Compare CT and MRI for the detection of chronic middle ear cholesteatoma mastoiditis.Analysis of CT and MRI manifestations of patients with chronic middle ear mastoiditis.With surgical pathologic examination results as the gold standard, compare MRI- DWI, CT can cholesteatoma lesions in patients with chronic middle ear mastoiditis accuracy and sensitivity, specific degrees.The consistency of MRI-DWI, CT and pathological examination was analyzed.Result:The sensitivity, specificity and accuracy of CT were 51.7%, 83.1% and 72.7% respectively.The Kappa value of consistency test between CT and surgical pathological examination results was Kappa = 0.360, P=0.001. There was a statistical difference in Kappa value, indicating low consistency .The sensitivity of MRI-DWI was 62.1%, the specificity was 89.8%, and the accuracy was 80.7%, The consistency test between the results of MRI-DWI and surgical pathological examination was Kappa =0.543, P<0.001, and there was a statistical difference in Kappa value with moderate consistency.Conclusion:The diagnostic value of MRI-DWI in cholesteatoma of chronic middle ear mastoiditis is higher than that of CT, and CT provides better spatial positioning. The two are complementary technologies, and the combined application of the two can provide better preoperative evaluation of cholesteatoma and ossicular chain status, and provide certain guidance value for the surgeon to choose a better surgical method and approach.