搏动性耳鸣的CT与MRI影像分析  

Analysis of CT and MRI in pulsatile tinnitus

作　　者：杜昱平[1] 张永顺[2] 周永清[1] 祝玉芬 

机构地区：[1]解放军白求恩国际和平医院放射科,河北石家庄,050082 [2]解放军白求恩军医学院影像教研室

出　　处：《实用放射学杂志》2015年第1期24-27,34,共5页Journal of Practical Radiology

摘　　要：目的：对比搏动性耳鸣的高分辨率 CT（HRCT）与 MRI CE 三维扰相梯度回波序列（three-dimensional spoiled gradient echo sequences,3D-SPGR）的影像学表现,评价其在诊断搏动性耳鸣（PT）中的应用价值。方法在已确诊的 PT 患者中选择同时行颞骨 HRCT 及 MRI CE 3D-SPGR 的15例,回顾性分析该15例 PT 患者的影像学资料,将 CT 与 MRI 检查结果对照分析,并总结2种检查方法对 PT 病因的显示。结果在15例患者中,8例9侧乙状窦异常,包括乙状窦憩室4侧,乙状窦裸露5侧；8侧伴有优势乙状窦；8例患者显示10侧颈静脉球高位；4例显示5侧粗大乳突导静脉；1例双侧半规管裂；1例鼓室球瘤；1例小血管压迫蜗神经。结论MRI CE 3D-SPGR 检查能准确地显示颅底部动、静脉血管的异常,骨结构的破坏及骨质的缺损需颞骨 HRCT 确诊,而 HRCT 在显示粗大的乳突导静脉以及小血管压迫蜗神经上逊色于 MRI CE 3D-SPGR。Objective To investigate the changes of pulsatile tinnitus on HRCT and MRI CE 3D-SPGR image.Methods CT and MRI images of 1 5 pulsatile tinnitus patients were retrospective analysis.All 1 5 patients underwent temporal bone HRCT and MRI CE 3D-SPGR scan.Abnormal changes on CT and MRI image,which caused the pulsatile tinnitus,were compared.Results In 1 5 patients,9 sides （8 cases）showed abnormal sigmoid sinuses including 4 sides of sigmoid sinuses diverticulum,5 sides sigmoid sinu-ses uncovering,8 sides dominant sigmoid sinuses.The high jugular bulb was showed in 10 sides （8 cases）,the thick emissaria mas-toidea in 5 sides （4 cases）,bilateral semicircular canal dehiscence in one case,glomus tympanicum tumor in one case and the cochle-ar nerve was constricted by small vessel in one case.Conclusion Cranial base vessel abnormity can be visualized more precisely on MRI CE 3D-SPGR image than that on HRCT.On the contrary,the detection of temporal bone abnormalities is superior on HRCT.

关 键 词：搏动性耳鸣 计算机体层成像 磁共振成像 

分 类 号：R764.45[医药卫生—耳鼻咽喉科] R814.42[医药卫生—临床医学]