血管搏动性耳鸣双能量CTA+CTV及4D Flow MRV分析  

Analysis of vascular pulsatile tinnitus using dual-energy CTA+CTV and 4D Flow MRV

作　　者：刘善凤 孙立新 王林省 胡娜 刘从涛 赵慧 李小芹 LIU Shanfeng;SUN Lixin;WANG Linsheng;HU Na;LIU Congtao;ZHAO Hui;LI Xiaoqin(Department of Imaging Center,Shandong Second Provincial General Hospital,Jinan 250023,China)

机构地区：[1]山东省第二人民医院影像中心,山东济南250023

出　　处：《医学影像学杂志》2025年第2期20-23,共4页Journal of Medical Imaging

基　　金：山东省医药卫生科技发展计划项目(编号:202309010361)。

摘　　要：目的分析血管搏动性耳鸣(pulsatile tinnitus,PT)颅脑双能量CTA+CTV及4D Flow MRV的影像学表现,探讨其可能病因。方法选取本院诊断单侧血管PT的451例患者影像学资料,均行颅脑双能量CTA+CTV检查,其中204例同时行4D Flow MRV检查。结果1)CTA+CTV:417例(92.46%)显示异常,其中静脉源性异常373例(82.70%)中表现为横窦-乙状窦管腔形态异常(狭窄、扩张)合并窦板骨质缺失221例(49.00%),乙状窦憩室136例(30.16%),颈静脉球高位并憩室16例(3.54%);动脉源性异常44例(9.76%);2)4D Flow MRV:流线图显示横窦-乙状窦复杂血流状态180例(88.23%),其中横窦狭窄处高速血流并下游湍流88例(43.14%),横窦狭窄处高速血流并下游憩室形成16例(7.84%),横窦狭窄处高速血流33例(16.18%),横窦-乙状窦移行区湍流43例(21.08%)。结论横窦-乙状窦管腔形态异常(狭窄、扩张)合并窦板骨质缺失及乙状窦憩室是本组血管PT患者常见的可能病因,由4D Flow MRV流线图推断横窦狭窄处高速血流导致下游横窦-乙状窦移行区湍流可能是静脉性PT产生的常见原因。Objective To analyze the imaging manifestations of cranial dual-energy CTA+CTV and 4D Flow MRV in patients with pulsatile tinnitus(PT)and to explore its possible causes.Methods A retrospective analysis was conducted on the imaging data of 451 patients diagnosed with unilateral vascular PT in the tinnitus department of our hospital.Among them,451 patients underwent cranial dual-energy CTA+CTV examination,and 204 patients underwent 4D Flow MRV examination simultaneously.Results 1)Via CTA+CTV test,417 cases(92.46%)showed abnormalities.A total of 373 cases(82.70%)had venous abnormalities,manifesting as 221 cases(49.00%)of abnormal morphology of the transverse sinus-sigmoid sinus lumen(stenosis,dilation)combined with sinus plate bone loss,136 cases(30.16%)of sigmoid sinus diverticulum,and 16 cases(3.54%)of high jugular bulb with diverticulum.A total of 44 cases(9.76%)had arterial abnormalities;and 2)By 4D Flow MRV examination,180 cases(88.23%)showed complex blood flow patterns in the transverse sinus-sigmoid sinus,in which 88 cases(43.14%)had high-speed blood flow at the stenotic site of the transverse sinus and turbulence at the downstream transition site of the transverse sinus-sigmoid sinus,16 cases(7.84%)had high-speed blood flow at the stenotic site of the transverse sinus,turbulence at the downstream transition site of the transverse sinus-sigmoid sinus,and diverticulum formation,33 cases(16.18%)had high-speed blood flow only at the stenotic site of the transverse sinus,and 43 cases(21.08%)had turbulence only at the transition site of the transverse sinus-sigmoid sinus.Conclusion Abnormal morphology of the transverse sinus-sigmoid sinus lumen(stenosis,dilation)combined with sinus plate bone loss and sigmoid sinus diverticulum are common causes in this group of patients with vascular PT.It is inferred from the streamline diagram of 4D Flow MRV that the turbulence in the downstream transverse sinus-sigmoid sinus transition zone caused by high-speed blood flow at the transverse sinus stenosis may be the common caus

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] R814.42[医药卫生—临床医学] R445.2