Dai Yuan-yuan, Sha Yan, Zhang Fang, Huang Wen-hu
Department of Radiology, EYE and ENT Hospital of Fudan University, Shanghai 200031, China.
Department of Radiology, EYE and ENT Hospital of Fudan University, Shanghai 200031, China. Email:
Zhonghua Yi Xue Za Zhi. 2013 Sep 3;93(33):2617-21.
To improve the imaging diagnosis accuracy on masses of temporal bone associated with pulsatile tinnitus.
The CT and MRI features of masses in temporal bone associated with pulsatile tinnitus in 32 cases, confirmed by pathology, were retrospectively analyzed.
They were grouped into two according to the jugular bulb involved or not. In the group involving the jugular bulb, there were 5 cases with glomus jugular, 2 cases of them presented the feature of "salt-pepper". There were 5 cases with middle ear carcinoma, which presented the masses in the tympanic cavity and antrum, extended to the external auditory canal and eroded the eustachian tube and jugular bulb. There were 3 cases with endolymphatic sac tumors, which presented multiple bony spicules on CT images and high signal on T1-weighted images. There was 1 case with metastatic tumor, which extensively eroded temporal and occipital bone, involved the jugular bulb, presented intermediate signal on T1-weighted images and intermediate or high signal on T2-weighted images, moderately enhanced following contrast administration. In the group not involving the jugular bulb, there were 15 cases with tympanic glomus, without ossicles and tympanic erosion, 7 cases of them limited to the promontory, 7 cases of them filled the tympanic cavity and antrum and 5 cases extended deep into the external auditory canals, 1 case extended to the mastoid, 12 cases intensely enhanced with gadolinium. There were 2 cases with cholesterol granulomas of the middle ear, which presented the masses in the tympanic cavity and antrum and high T1-weighted and T2-weighted signal. There was 1 case with facial nerve hemangioma, which presented the enlargement and mass of the geniculate fossa involving the tympanic segment of facial nerve with the erosion and displacement of ossicles. On MR images, the mass was intensely enhanced after contrast administration.
Among the masses of temporal bone associated with pulsatile tinnitus, the paragangliomas are the most common and easy to be diagnosed by their imaging features. While the other masses of temporal bone are uncommon, they could also be diagnosed accurately by clinical and imaging characteristics.
提高对与搏动性耳鸣相关的颞骨肿物的影像诊断准确性。
回顾性分析32例经病理证实的与搏动性耳鸣相关的颞骨肿物的CT及MRI特征。
根据颈静脉球是否受累分为两组。颈静脉球受累组中，颈静脉球瘤5例，其中2例表现为“椒盐”征；中耳癌5例，肿物位于鼓室及鼓窦，可延伸至外耳道，侵犯咽鼓管及颈静脉球；内淋巴囊肿瘤3例，CT表现为多发骨针，T1加权像呈高信号；转移瘤1例，广泛侵蚀颞骨及枕骨，累及颈静脉球，T1加权像呈等信号，T2加权像呈等或高信号，增强扫描呈中度强化。颈静脉球未受累组中，鼓室球瘤15例，无听小骨及鼓膜破坏，其中7例局限于岬部，7例充满鼓室及鼓窦，5例深入外耳道，1例延伸至乳突，12例钆增强扫描呈明显强化；中耳胆固醇肉芽肿2例，肿物位于鼓室及鼓窦，T1加权像及T2加权像均呈高信号；面神经血管瘤1例，膝状窝扩大并形成肿物，累及面神经鼓室段，听小骨受侵蚀及移位，MR增强扫描肿物呈明显强化。
在与搏动性耳鸣相关的颞骨肿物中，副神经节瘤最常见，其影像表现易于诊断。其他颞骨肿物虽少见，但结合临床及影像特征也可准确诊断。
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