Liu Zhaohui, Dong Cheng, Wang Xiao, Han Xiaoyi, Zhao Pengfei, Lv Han, Li Qing, Wang Zhenchang
Department of Radiology, Capital Medical University, Beijing Tongren Hospital, NO.1, Dongjiaominxiang Road, Beijing, 100730, China,
Neuroradiology. 2015 Jul;57(7):747-53. doi: 10.1007/s00234-015-1517-5. Epub 2015 Apr 7.
The mechanism of occurrence of sigmoid sinus dehiscence/diverticulum (SSDD) in pulsatile tinnitus (PT) patients remains under debate. Its association with idiopathic intracranial hypertension (IIH) lacks evidence, which is important for therapeutic planning and improving the clinical outcome. This study aimed to evaluate the association between SSDD and IIH by comparing the prevalence of several established imaging features of IIH between PT patients with SSDD and healthy volunteers.
Thirty-three unilateral PT patients with SSDD identified on CT images and 33 age- and sex-matched healthy volunteers underwent T1-weighted volumetric magnetic resonance imaging (MRI). The optic nerve, pituitary gland, transverse sinus, and ventricles were assessed. The prevalence of established IIH imaging features was compared between the two groups. Furthermore, the PT patients were divided into two subgroups: PT patients with dehiscence only and PT patients with diverticulum. The same statistical analysis was performed on each pathophysiologic entity respectively.
The PT patients with SSDD showed a significantly higher prevalence of empty sella (P < 0.001), flattened posterior sclera (P = 0.001), vertical tortuosity of the optic nerve (P = 0.001), protrusion of the optic nerve (P = 0.006), transverse sinus stenosis (P = 0.011), and distension of the optic nerve sheath (P = 0.000). There were no significant differences between the PT and control groups in the maximum widths of the third and fourth ventricles and the lateral ventricle size. In contrast to controls, the imaging findings persisted in both of pathophysiologic entities, except for transverse sinus stenosis.
Several IIH imaging features occur more frequently in PT patients with SSDD than in healthy individuals, which suggests a potential correlation between SSDD with PT and IIH.
搏动性耳鸣（PT）患者乙状窦骨壁缺损/憩室（SSDD）的发生机制仍存在争议。其与特发性颅内高压（IIH）的关联缺乏证据，而这对治疗方案的制定和改善临床结果至关重要。本研究旨在通过比较患有SSDD的PT患者与健康志愿者之间几种已确定的IIH影像学特征的患病率，来评估SSDD与IIH之间的关联。
33例经CT图像确诊为单侧SSDD的PT患者和33例年龄及性别匹配的健康志愿者接受了T1加权容积磁共振成像（MRI）检查。对视神经、垂体、横窦和脑室进行评估。比较两组之间已确定的IIH影像学特征的患病率。此外，将PT患者分为两个亚组：仅患有骨壁缺损的PT患者和患有憩室的PT患者。分别对每个病理生理实体进行相同的统计分析。
患有SSDD的PT患者出现空蝶鞍（P < 0.001）、后巩膜扁平（P = 0.001）、视神经垂直迂曲（P = 0.001）、视神经突出（P = 0.006）、横窦狭窄（P = 0.011）和视神经鞘扩张（P = 0.000）的患病率显著更高。PT组和对照组在第三和第四脑室的最大宽度以及侧脑室大小方面无显著差异。与对照组相比，除横窦狭窄外，两种病理生理实体的影像学表现均持续存在。
几种IIH影像学特征在患有SSDD的PT患者中比在健康个体中更频繁出现，这表明SSDD与PT和IIH之间可能存在相关性。
