乙状窦沟骨板缺损致搏动性耳鸣的CT特征分析  

CT analysis of dehiscent sigmoid plate presenting as pulsatile tinnitus

作　　者：刘兆会[1] 王国鹏 赵鹏飞[1] 王振常[3] 龚树生 鲜军舫[1] 粱熙虹[1] 曾荣 吕晗[1] 

机构地区：[1]首都医科大学附属北京同仁医院放射科,100730 [2]耳鼻咽喉头颈外科 [3]首都医科大学附属北京友谊医院放射科

出　　处：《中华医学杂志》2014年第3期195-197,共3页National Medical Journal of China

基　　金：国家自然科学基金（81171311,81371545）;北京市教委科技发展重点项目（KZ20110025029）;首都医科大学基础临床合作课题重点项目（13JL03）

摘　　要：目的分析以搏动性耳鸣为主要症状的乙状窦沟骨板缺损的CT特征。方法回顾性分析首都医科大学附属北京同仁医院2009—2012年11例乙状窦沟骨板缺损引起持续性单侧搏动性耳鸣患者的头颈部双期增强CT表现。结果CT显示乙状窦沟骨板缺损均位于耳鸣侧。术中和CT均能显示乙状窦沟骨板缺损共13个，位于乙状窦降部8个，乙状窦上曲3个，同时累及乙状窦上曲、降部2个，CT测量骨板缺损的最大左右径[（6．1±3．5）mm]和上下径[（4．2±1．9）mm]均明显大于术中测量的长径[（4．5±3．9）mm]和短径[（3．0±1．3）mm]。CT显示而术中未发现骨板缺损5个。9例患者脑静脉回流呈不均衡型，骨板缺损均位于静脉回流优势侧。2例脑静脉回流呈均衡型，骨板缺损均位于左侧。患者耳鸣侧颞骨均气化良好，颞骨气房及鼓室均富含气体。结论乙状窦沟骨板缺损多位于乙状窦上曲、降部前／外侧壁，好发于脑回流静脉优势及颞骨蜂房气化侧。Objective To evaluate the CT the characteristics of dehiscent sigmoid plate accompanied with pulsatile tinnitus （PT）. Methods Dual phase contrast enhancement CT data of 15 PT patients were analyzed retrospectively. Results Dehiscent sigmoid plate was located on the same side of PT in all patients. Thirteen defects had been showed in both CT images and surgery. Among of them, eight defects located on the descending segment, 3 on the superior curve, and the other 2 defects involved the superior curve and descending segment of sigmoid sinus simultaneously. The maximum anteroposterior and vertical diameters of defect measured in CT images were significant larger than that measured during surgery. There were still 5 defects showed in CT images, which did not been found during surgery. Among 9 patients with unilateral dominant brain venous systems, all the dehiscent sigmoid plates were seen on the dominant side. The other 2 patients showed co-dominant brain venous systems, whose the dehiscent sigmoid plates were on the left side. In addition, extensive pneumatized temporal bone filled with air was found in all patients. Conclusion Dehiscent sigmoid plate co mmonly located on the anterior, lateral, or anterolateral wall of the superior curve or descending segment of the sigmoid plate, which usually coexist with the strong unilateral dominant brain venous system and extensive temporal bone pneumatization.

关 键 词：搏动性耳鸣 体层摄影术 X线计算机 磁共振成像 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]