中耳乳突高分辨率CT联合头颈部血管造影对 血管源性耳鸣的诊断价值探讨(1)
【摘要】 目的：探讨中耳乳突高分辨率CT(HRCT)联合头颈部血管造影(CTA+CTV)对血管源性耳鸣的诊断价值。方法：选择2014年1月1日-2018年12月31日至笔者所在医院进行手术治疗的患者68例进行临床研究。根据患者血管有无明显畸形分组，有畸形患者为观察组，共41例，无血管畸形患者为对照组，共27例，所有患者均给予中耳乳突HRCT联合头颈部CTA、CTV检查。以手术结果为最终诊断标准，观察HRCT和CTA+CTV联合检查对患者血管畸形诊断的特异度和敏感度、两组患者手术前后血管源性耳鸣变化情况及患者临床疗效。结果：HRCT和CTA+CTV联合检查对患者血管畸形诊断的敏感度为95.12%(39/41)，特异度为92.59%(25/27)。结论：中耳乳突HRCT和CTA+CTV联合检查对于血管源性耳鸣诊断具有重要的临床应用价值，能够为手术方案的制定提供可靠依据。
【关键词】 中耳乳突高分辨率CT; 头颈部血管造影; 血管源性耳鸣
doi：10.14033/j.cnki.cfmr.2019.12.028 文献标识码 B 文章编号 1674-6805(2019)12-00-03
Diagnostic Value of High Resolution CT of Middle Ear and Mastoid Process Combined with Head and Neck Angiography in Vascular Tinnitus/LIU Qinyu，LIN Miaohong，AI Dongliang，et al.//Chinese and Foreign Medical Research，2019，17(12)：-65
【Abstract】 Objective：To evaluate the diagnostic value of high resolution CT(HRCT) of middle ear and mastoid process combined with head and neck angiography(CTA，CTV) in vascular tinnitus.Method：68 patients underwent surgical treatment from January 1，2014 to December 31，2018 were selected for clinical study.The patients were divided into observation group(41 cases) and control group(27 cases).All patients were examined by HRCT combined with head and neck CTA and CTV.The specificity and sensitivity of HRCT and CTA+CTV combined examination in the diagnosis of vascular malformations were observed.The changes of vascular tinnitus before and after operation and the clinical efficacy of the two groups were also observed.Result：The sensitivity and specificity of HRCT and CTA+CTV in the diagnosis of vascular malformation were 95.12%(39/41) and 92.59%(25/27).Conclusion：The combined examination of HRCT and CTA+CTV of middle ear and mastoid process has important clinical value in the diagnosis of vascular tinnitus，and can provide reliable basis for the formulation of surgical plan.
【Key words】 High resolution CT of middle ear and mastoid process; Head and neck angiography; Vascular tinnitus
First-author’s address：Jiexi County Hospital of Traditional Chinese Medicine，Jiexi 515431，China
血管源性耳鳴也称为搏动性耳鸣，以患者能听见自己动脉中流动的血液搏动声音为主要临床症状，通常单侧出现，在按压同侧颈动脉时耳鸣消失或显著减轻[1]。导致血管源性耳鸣出现的病因多种，血压异常、血管瘤、血管畸形均可导致该症状出现，对患者的日常生活造成严重影响[2]。对于血管源性耳鸣的诊断一直是临床研究的重点课题。近年来中耳乳突高分辨率CT(HRCT)联合头颈部血管造影(CTA、CTV)在临床中的应用为血管源性耳鸣的诊断提供了依据，也为进一步治疗方案的选择创造了条件[3]。为了观察中耳乳突HRCT联合CTA、CTV在血管源性耳鸣中的诊断价值，笔者所在医院进行了本次研究，现报道如下。
1 资料与方法
1.1 一般资料
选择2014年1月1日-2018年12月31日在笔者所在医院进行手术治疗的患者68例进行临床研究。纳入标准：确诊为血管源性耳鸣的患者[4]。排除标准：(1)合并神经性耳鸣等其他原因导致的耳鸣患者。(2)合并中耳炎等中耳严重病变患者。, http://www.100md.com(刘钦裕 林妙红 艾东亮 黄俊朋 林鑫妹 马焕杰)
【关键词】 中耳乳突高分辨率CT; 头颈部血管造影; 血管源性耳鸣
doi：10.14033/j.cnki.cfmr.2019.12.028 文献标识码 B 文章编号 1674-6805(2019)12-00-03
Diagnostic Value of High Resolution CT of Middle Ear and Mastoid Process Combined with Head and Neck Angiography in Vascular Tinnitus/LIU Qinyu，LIN Miaohong，AI Dongliang，et al.//Chinese and Foreign Medical Research，2019，17(12)：-65
【Abstract】 Objective：To evaluate the diagnostic value of high resolution CT(HRCT) of middle ear and mastoid process combined with head and neck angiography(CTA，CTV) in vascular tinnitus.Method：68 patients underwent surgical treatment from January 1，2014 to December 31，2018 were selected for clinical study.The patients were divided into observation group(41 cases) and control group(27 cases).All patients were examined by HRCT combined with head and neck CTA and CTV.The specificity and sensitivity of HRCT and CTA+CTV combined examination in the diagnosis of vascular malformations were observed.The changes of vascular tinnitus before and after operation and the clinical efficacy of the two groups were also observed.Result：The sensitivity and specificity of HRCT and CTA+CTV in the diagnosis of vascular malformation were 95.12%(39/41) and 92.59%(25/27).Conclusion：The combined examination of HRCT and CTA+CTV of middle ear and mastoid process has important clinical value in the diagnosis of vascular tinnitus，and can provide reliable basis for the formulation of surgical plan.
【Key words】 High resolution CT of middle ear and mastoid process; Head and neck angiography; Vascular tinnitus
First-author’s address：Jiexi County Hospital of Traditional Chinese Medicine，Jiexi 515431，China
血管源性耳鳴也称为搏动性耳鸣，以患者能听见自己动脉中流动的血液搏动声音为主要临床症状，通常单侧出现，在按压同侧颈动脉时耳鸣消失或显著减轻[1]。导致血管源性耳鸣出现的病因多种，血压异常、血管瘤、血管畸形均可导致该症状出现，对患者的日常生活造成严重影响[2]。对于血管源性耳鸣的诊断一直是临床研究的重点课题。近年来中耳乳突高分辨率CT(HRCT)联合头颈部血管造影(CTA、CTV)在临床中的应用为血管源性耳鸣的诊断提供了依据，也为进一步治疗方案的选择创造了条件[3]。为了观察中耳乳突HRCT联合CTA、CTV在血管源性耳鸣中的诊断价值，笔者所在医院进行了本次研究，现报道如下。
1 资料与方法
1.1 一般资料
选择2014年1月1日-2018年12月31日在笔者所在医院进行手术治疗的患者68例进行临床研究。纳入标准：确诊为血管源性耳鸣的患者[4]。排除标准：(1)合并神经性耳鸣等其他原因导致的耳鸣患者。(2)合并中耳炎等中耳严重病变患者。, http://www.100md.com(刘钦裕 林妙红 艾东亮 黄俊朋 林鑫妹 马焕杰)