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1、256放射学实践2011年3月第26卷第3期RadiolPractice,Mar2011,Vol26,No.3头颈部影像学专题搏动性耳鸣的CT和DSA梁熙虹,陈光利,龚树生,刘兆会,李静,王征宇,夏寅,王振常,鲜军舫摘要目的:采用CT和DSA探讨疗效显著的搏动性耳鸣的病因,总结针对搏动性耳鸣患者的最佳影像学检查方法。方法:回顾性分析102例经手术或介入治疗后搏动性耳鸣消失或明显减轻患者的CT和DSA资料,患者均行颅面部双期增强CT扫描和DSA检查。结果:102例引起搏动性耳鸣的病变包括颈内动脉海绵窦瘘(CCF)41例,海绵窦区及横窦、乙状窦区硬脑膜动
2、静脉瘘25例,乙状窦憩室15例,颈静脉球体瘤12例,鼓室球瘤5例,颅外动静脉畸形3例,面颊部动静脉瘘1例。CT显示CCF39例,显示率为95.1%;硬脑膜动静脉瘘18例,显示率为72%;颅外动静脉畸形2例,显示率为66.7%;对乙状窦憩室、颈静脉球体瘤及鼓室球瘤的显示率为100%。DSA对所有病变均能显示,DSA显示血管畸形的能力明显优于CT(P=0.004),CT对CCF的显示率明显高于对血管畸形的显示率(P=0.006)。结论:疗效显著的搏动性耳鸣常见病因是CCF和硬脑膜动静脉瘘,双期CT增强扫描和DSA是寻找病原因的重要方法,CT可取代DSA作为筛选方法。
3、关键词搏动性耳鸣;体层摄影术,X线计算机;血管造影术中图分类号R764.45;R814.42;R814.43文献标识码A文章编号10000313(2011)03025604CTandDSAevaluationofpulsatiletinnitusLIANGXihong,CHENGuangli,GONGShusheng,etal.DepartmentofRadiology,CapitalMedicalUniversity,BeijingTongrenHospital,Beijing100730,P.R.ChinaAbstrac
4、tObjective:Tostudythecausesofpulsatiletinnitus(PT)withCTandDSAandevaluatetheoptimalimagingmeansfordetectingunderlyingcausesofPT.Methods:Weretrospectivelystudied102casesofPTprovenbysurgeryorinterventionaltherapy.Allpatientsunderwentcerebraldigitalsubtractionangiography(DSA)anddualp
5、hasecontrastenhancedCT.Results:Amongthe102cases,therewere41caseswithcarotidcavernousfistula(CCF),25caseswithcerebralduralarteriovenousfistula(dAVF),15caseswithsigmoidsinusdiverticula,12caseswithglomusjugularetumor,5caseswithglomustympanicumtumor,3caseswithextracranialarteriovenousma
6、lformation(AVM)andonecasewitharteriovenousfistulainthecheek.TheaccuracyofCTindiagnosingCCF,dAVFandextracranialAVMwas95.1%(39/41),72%(18/25)and66.7(2/3)respectively.TheaccuracyofCTindiagnosingsigmoidsinusdiverticulum,glomusjugularetumorandglomustympanicumtumorreached100%.Theaccuracyo
7、fDSAinthediagnosisofabovediseaseswere100%.DSAwassignificantlybetterthanCTfordemonstratingvascularmalformationandthedetectionrateofCTwassignificantlyhigherinCCFthaninvascularmalformations.Conclusion:ThemostcommontreatablecausesofPTareCCFanddAVF.DSAisthemostdefinitivemethodfordetecting
8、underlyingca
