颞骨双期增强CT诊断搏动性耳鸣病因的价值研究

Value of temporal bone dual phase contrast enhancement computed tomography in diagnosing causes of pulsatile tinnitus

目的探讨颞骨双期增强CT（DPCT）诊断搏动性耳鸣（PT）病因的价值。方法收集首都医科大学附属北京同仁医院2009-2012年行DPCT检查的单侧PT患者157例，其中同期行颞骨HRCT检查71例，耳部MRI80例，全脑DSA89例。对比分析DPCT与HRCT、MRI和DSA对胛病因诊断能力。结果71例行HRCT和DPCT的患者中，共发现68个病因，DPCT的诊断率100％，明显高于HRCT的77．9％。80例行MRI和DPCT的患者中，共有83个病因，DPCT的诊断率94．0％，明显高于MRI的8．4％。89例行DSA和DPCT的患者中，共有99个病因，DPCT的诊断率91．9％，明显高于DSA的15．2％。结论DPCT对PT病因的诊断率明显高于其他影像检查，可作为该病的首选检查方法。

Objective To evaluate the value of temporal bone dual phase contrast enhancement computed tomngraphy （DPCT） in diagnosing the causes of pulsatile tinnitus （PT） . Methods We retrospectively analyzed the DPCT findings of 157 patients with unilateral PT. Temporal bone High-resolution CT （HRCT） was performed in 71 patients, magnetic resonance imaging （MRI） in 80 and digital subtraction angiography （DSA） in 89. Results In 71 patients with both DPCT and HRCT scan, a total of 68 causes were found. The accuracy of DPCT was 100% it was significant higher than that of HRCT （77.9%）. In 80 patients with both DPCT and MRI, 83 causes were known. The accuracy of DPCT （94.0%） was significantly higher than that of MRI （8.4%）. In 89 patients with both DPCT and DSA scan, 99 causes were identified. The accuracy of DPCT was 91.9% and it was significantly higher than that of DSA （ 15.2% ）. Conclusion DPCT may be an ideal imaging modality for diagnosing the causes of PT.