偶发性乙状窦憩室的CT影像研究

CT Imaging Study of Incidental Sigmoid Sinus Diverticulum

目的基于CTA评估无搏动性耳鸣的成人乙状窦憩室(SSD)发生情况及影像特征。方法回顾性评估符合纳入标准的4572例受检者的头颈部CTA图像。通过重组横断位及冠状位图像观察有无SSD,并评估SSD大小、形态、部位及伴发征象,比较性别、侧别、不同年龄段间SSD发生率差异。结果成人SSD发生率约1.33%(61/4572例),女性较男性多见(2.23%vs 0.82%,P=0.000),右侧较左侧多见(0.98%vs 0.42%,P=0.001),单侧为主(95.1%,58/61)。18~39岁组、40~49岁组、50~59岁组、60~69岁组、≥70岁组间SSD发生率差异均无统计学意义(P>0.05)。SSD颈高、颈宽、颈深、最大横截面积分别约(6.73±2.60)mm、(4.91±1.63)mm、4.55 mm(3.53 mm,5.90 mm)、17.50 mm^(2)(13.00 mm^(2),26.75 m^(2)),窄颈、宽颈分别占40.6%、59.4%,位于乙状窦上曲段、降段、下曲段者分别占59.3%、26.6%、14.1%。伴发乙状窦周骨壁缺失、同侧静脉回流优势、同侧横窦狭窄、板障静脉汇入憩室者分别占51.6%、60.9%、39.1%、20.3%。结论成人SSD并不罕见,其形成可能与血流因素有关,与年龄因素无明显关联;CTA可显示SSD相关特征。

Objective To evaluate the occurrence and imaging characteristics of sigmoid sinus diverticulum(SSD)in adults without pulsatile tinnitus based on computed tomography angiography(CTA).Methods The CTA images of 4572 patients who met the entry criteria were retrospectively reviewed.Quantitative and qualitative analysis of the SSD,including the size,morphology,location and accompanying signs,were performed.And the incidences of different sexes,sides and age groups were compared.Results The incidence of SSD was about 1.33%(61/4572 cases),which was more common in females than males(2.23%vs 0.82%,P=0.000)and more common on the right side than on the left(0.98%vs 0.42%,P=0.001).The majority of subjects is unilateral(95.1%,58/61 cases).There was no statistically significant difference in the incidence of SSD between different ages.Conclusion SSD is not rare in adults,and its formation may be related to blood flow,but not age;The characteristics of SSD can be well shown on CTA.