Fig 3.

MR images of an empyema in the postoperative cavity of the right middle ear. A, On the transverse postgadolinium spin-echo T1-weighted image, a lesion with low signal intensity surrounded by a rim of enhancing tissue is shown. B, At this location, a high signal intensity lesion is shown on the axial turbo spin-echo T2-weighted image. C, Transverse non-EPI DWI sequence shows the increased DW signal intensity of the lesion. The calculated ADC value of the lesion (0.932 × 10⁻³ mm²/s) was not typical for an empyema. Imaging findings alone cannot definitely differentiate an empyema from a cholesteatoma.