Krishnan A, Mattox D E, Fountain A J, Hudgins P A
Neuroradiology Division, Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322, USA.
AJNR Am J Neuroradiol. 2006 Sep;27(8):1635-8.
Pulsatile tinnitus (PT), a common disorder, can be caused by a variety of otologic and vascular lesions. Various imaging modalities, including CT, MR imaging and angiography, and conventional angiography, have been used in the assessment of PT. Ideally, a single imaging study to evaluate for the largest variety of etiologies would be optimal. In our study, we examine the potential for CT arteriography and venography (CTA/V) in the evaluation of PT.
Sixteen patients with PT were prospectively evaluated by an otolaryngologist, had a normal otologic examination, and were referred for a CTA/V. All examinations were performed on a 16-section multidetector CT. The carotid bifurcations, internal carotid artery course, transverse and sigmoid sinuses, jugular foramen, internal jugular vein, sella turcica, and temporal bones were evaluated.
Seven of the 16 patients had lesions on CTA/V that could account for their PT. Examples of pathologic conditions in the series included a significantly dominant venous system, a venous diverticulum with stricture, and a transverse sinus stenosis.
Preliminary findings indicate that CTA/V can be a valuable imaging tool in the assessment of PT. With this technique, arterial, venous, middle, and inner ear causes of PT can be excluded.
搏动性耳鸣(PT)是一种常见病症,可由多种耳科和血管病变引起。包括CT、磁共振成像及血管造影以及传统血管造影在内的各种成像方式已用于PT的评估。理想情况下,能评估最多病因的单一成像研究将是最佳的。在我们的研究中,我们探讨了CT血管造影和静脉造影(CTA/V)在PT评估中的潜力。
16例PT患者由耳鼻喉科医生进行前瞻性评估,耳科检查正常,并被转诊进行CTA/V检查。所有检查均在16层多排CT上进行。评估了颈动脉分叉、颈内动脉走行、横窦和乙状窦、颈静脉孔、颈内静脉、蝶鞍和颞骨。
16例患者中有7例在CTA/V上发现病变,这些病变可解释其PT。该系列中的病理情况包括明显占优势的静脉系统、伴有狭窄的静脉憩室和横窦狭窄。
初步研究结果表明,CTA/V可成为PT评估中有价值的成像工具。通过该技术,可以排除PT的动脉、静脉、中耳和内耳病因。