静脉性耳鸣患者蛛网膜颗粒内脑疝对高跨狭窄压力梯度的诊断效能研究  

Diagnostic Efficiency of Brain Herniation into Arachnoid Granulation for High Trans-stenostic Pressure Gradient in Patients with Venous Tinnitus

作　　者：丁贺宇 杨毅 韩旭[1] 黄炎 代驰航 王国鹏[3] 龚树生[3] 金龙[4] 王振常[1] 赵鹏飞[1] DING He-yu;YANG Yi;HAN Xu;HUANG Yan;DAI Chi-hang;WANG Guo-peng;GONG Shu-sheng;JIN Long;WANG Zhen-chang;ZHAO Peng-fei(Department of Radiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Neurology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Otorhinolaryngology,Head and Neck Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Intervention,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院放射科,北京100050 [2]首都医科大学附属北京友谊医院神经内科,北京100050 [3]首都医科大学附属北京友谊医院耳鼻喉头颈外科,北京100050 [4]首都医科大学附属北京友谊医院介入科,北京100050

出　　处：《中国CT和MRI杂志》2024年第6期1-3,共3页Chinese Journal of CT and MRI

基　　金：国家自然科学基金(82202098,82171886,61931013);北京市自然科学基金(7222301)。

摘　　要：目的探讨静脉性耳鸣患者蛛网膜颗粒内脑疝(brain herniation into arachnoid granulation,BHAG)对于横窦跨狭窄压力梯度(tra ns-stenostic pressure gradient,TPG)升高(≥8m m H g)的诊断效能。方法回顾性分析2010年11月至2023年10月于首都医科大学附属北京友谊医院住院的静脉性耳鸣患者临床及影像学资料,所有患者均行静脉窦非增强M RV(non-contrast enhanced MR venography,NCE-MRV)、全脑MPRAGE及3D-T_(2)WI扫描,并经DSA行静脉窦测压,将患者分为A(TPG<8 mm Hg)、B(TPG≥8 mm Hg)两组。结合全脑MPRAGF及3D-T_(2)WI的标准冠状面图像,评价是否存在BHAG。对A、B两组BHAG发生率是否存在差异进行卡方检验;计算BHAG对于诊断高TPG(≥8 mm Hg)特异度、灵敏度、准确度、阳性预测值及阴性预测值。结果共73例患者符合纳排标准(男性9例,女性64例),年龄37.0(46.5-30.0)岁,其中A组(TPG<8 mm Hg)46例,B组(TPG≥8 mm Hg)27例。BHAG患者共12例(12/73,16.44%),A、B两组BHAG发生率存在统计学差异(χ^(2)值=10.96,P<0.001)。BHAG诊断高TPG(≥8mmHg)的特异度为95.65%、灵敏度为37.04%、准确度为73.97%、阳性预测值为83.33%,阴性预测值为72.13%。结论BHAG在静脉性耳鸣患者中并不罕见,可用于辅助预估有无TPG升高。Objective To explore the diagnostic efficiency of Brain herniation into arachnoid granulation(BHAG)for high Trans-stenostic pressure gradient(TPG,≥8 mm Hg) in patients with venous tinnitus.Methods Clinical and imaging data of patients with unilateral Pulsatile tinnitus(PT) admitted to Beijing Friendship Hospital,Capital Medical University from November 2019 to October 2023 were retrospectively analyzed.All patients underwent Non-contrast enhanced MR venography(NCE-MRV),whole brain MPRAGE and 3D-T_(2WI) scanning,and venous sinus pressure was measured by DSA.Patients were divided into two groups:Group A(TPG <8 mm Hg) and Group B(TPG≥8 mm Hg).BHAG was evaluated in standard coronal images of whole brain MPRAGE and 3D-T_2WI.Chi-square test was performed to determine whether the incidence of BHAG was different between Group A and Group B.The specificity,sensitivity,accuracy,positive predictive value and negative predictive value of BHAG were calculated for the diagnosis of high TPG(≥ 8 mm Hg).Results A total of 73 patients(9 males and 64 females),aged 37.0(46.5-30.0) years,met the exclusion criteria,including 46 patients in Group A(TPG <8 mm Hg) and 27 patients in Group B(TPG≥8 mm Hg).There were 12 patients with BHAG(12/73,16.44%),and the incidence of BHAG was significantly different between group A and group B(χ^(2) value=10.96,P<0.001).The specificity,sensitivity,accuracy,positive predictive value and negative predictive value of BHAG for diagnosis of high TPG(≥ 8 mm Hg) were 95.65%,37.04%,73.97%,83.33% and 72.13%,respectively.Conlusion BHAG is not uncommon in patients with venous tinnitus and can be used to the estimation of elevated TPG.

关 键 词：静脉性耳鸣 蛛网膜颗粒内脑疝 跨狭窄压力梯度 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]