基于4D流磁共振成像的乙状窦板裂开搏动性耳鸣的横窦血流特征
[Transverse sinus blood flow characteristics of pulsatile tinnitus with dehiscent sigmoid plate based on 4D flow MRI].
作者信息
Dai C H, Ding H Y, Lyu H, Qiu X Y, Li X S, Zeng R, Wang G P, Yang Z H, Gong S S, Wang Z C, Zhao P F
机构信息
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
出版信息
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Sep 7;59(9):897-901. doi: 10.3760/cma.j.cn115330-20230923-00112.
To investigate the hemodynamic characteristics of transverse sinus with sigmoid sinus wall dehiscence (SSWD) of pulsatile tinnitus (PT) based on 4D flow MRI. Retrospective analysis was performed on all patients admitted to Beijing Friendship Hospital, Capital Medical University from January 2019 to January 2021 for dehiscent sigmoid plate pulsatile tinnitus. A total of 26 patients (sides) who met the criteria and underwent 4D flow MRI were included. A total of 26 subjects (46 sides), matched 1∶1 according to gender and age, were included in the normal healthy control group. Nonparametric rank sum test, Student's test, and ANOVA were performed by SPSS 19.0 software. Binary Logistic regression was applied to the data with statistical significance. There were more patients with dominant drainage on the affected side in PT group than in control group (73.1% . 42.3%). The incidence of transverse with a focal intraluminal filling defect and tapered stenosis was higher than that in control group (21.7% . 69.2%; 17.4% . 42.3%). Average through-plane velocity and maximum through-plane velocity in PT group were higher than those in control group [(33.75±13.88) cm/s . (15.84±7.21) cm/s; (93.19±33.55) cm/s . (40.40±14.40) cm/s]. The middle part and proximal end of Flow (ml/s) in PT group were larger than those in control group [4.69 (2.87; 5.62) ml/s . 2.76 (1.67; 4.99) ml/s; 3.41 (2.16; 5.47) ml/s . 2.67 (1.68; 4.41) ml/s]. In control group, the velocity of transverse sinus changed relatively gently, while in PT group, the velocity of proximal sinus increased significantly. Binary Logistic regression showed that SSWD PT was independently correlated with proximal maximum flow velocity [=1.086(1.029-1.146),=0.003]. 4D flow MRI showed that the dominant drainage and higher velocity at the proximal end of the transverse sinus might be an important hemodynamic characteristics of dehiscent sigmoid plate pulsatile tinnitus.
基于四维血流磁共振成像（4D flow MRI）研究乙状窦壁骨质缺损（SSWD）型搏动性耳鸣（PT）患者横窦的血流动力学特征。对2019年1月至2021年1月首都医科大学附属北京友谊医院收治的所有乙状窦板骨质缺损型搏动性耳鸣患者进行回顾性分析。共纳入26例符合标准并接受4D flow MRI检查的患者（侧）。正常健康对照组纳入26例受试者（46侧），根据性别和年龄进行1∶1匹配。采用SPSS 19.0软件进行非参数秩和检验、t检验和方差分析。对具有统计学意义的数据应用二元Logistic回归分析。PT组患侧优势引流的患者多于对照组（73.1% 对42.3%）。横窦出现局灶性管腔内充盈缺损和锥形狭窄的发生率高于对照组（21.7% 对6.92%；17.4% 对4.23%）。PT组的平均层面内速度和最大层面内速度高于对照组[（33.75±13.88）cm/s对（15.84±7.21）cm/s；（93.19±33.55）cm/s对（40.40±14.40）cm/s]。PT组血流（ml/s）的中部和近端大于对照组[4.69（2.87；5.62）ml/s对2.76（1.67；4.99）ml/s；3.41（2.16；5.47）ml/s对2.67（1.68；4.41）ml/s]。对照组横窦速度变化相对平缓，而PT组近端横窦速度显著增加。二元Logistic回归分析显示，SSWD型PT与近端最大流速独立相关[比值比=1.086（1.029 - 1.146），P = 0.003]。4D flow MRI显示，横窦优势引流和近端较高流速可能是乙状窦板骨质缺损型搏动性耳鸣的重要血流动力学特征。
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