横窦-乙状窦憩室引起搏动性耳鸣的CT诊断

目的 探讨横窦-乙状窦憩室引起的搏动性耳鸣的CT表现.方法 搜集18例横窦-乙状窦憩室引起的搏动性耳鸣患者资料,分析其脑CT动静脉血管造影(CT Arteriography and Venography,CTA/CTV)检查的影像表现.结果 18例横窦-乙状窦憩室均发生在静脉窦优势引流侧;静脉窦双能量减影图像直观地显示横窦-乙状窦憩室,表现为静脉窦管腔局部呈囊袋样、指状及棘样突起;CTV图像能清楚地显示局部膨隆的静脉窦经邻近骨壁缺损处疝入邻近的乳突.结论 脑CTA/CTV检查对诊断横窦-乙状窦憩室引起的搏动性耳鸣具有重要的价值.     

基于影像学评估的乙状窦骨壁缺损相关搏动性耳鸣患者手术疗效分析

目的基于乙状窦骨壁重建术前、术后影像学改变及疗效分析,探讨乙状窦骨壁缺损相关搏动性耳鸣作用机制。方法选取我院乙状窦骨壁重建术治疗的搏动性耳鸣(PT)患者17例,回顾性分析患者术前、术后患侧颞骨高分辨率CT表现,明确相关临床病史,对比术前、术后颞骨CT的影像学改变,分析手术治疗效果相关影像学特征差异。结果手术治疗17例患者均为女性,平均年龄(42.9±9.9)岁,病程平均(1.94±1.93)年,右侧11例(64.71%)。手术治愈11例(64.71%),症状缓解3例(17.65%),治疗无效3例(17.65%)。所有患者缺损骨壁均得到修复,术后与术前相比耳鸣程度减低差异具有统计学意义(P<0.05)。耳鸣治愈及缓解患者乳突蜂房均存在大幅度的含气程度降低,而手术治疗无效患者的乳突蜂房含气状态与术前相比无明显改变。结论乙状窦骨壁重建术的疗效可能与术后乳突蜂房的含气状态改变密切相关。     

搏动性耳鸣乙状窦骨壁缺损与病程相关性研究

目的探讨乙状窦骨壁缺损(SSD)所致搏动性耳鸣(PT)颞骨影像学特点,以及SSD与病程关系。方法纳入乙状窦骨壁重建术治愈PT患者13例,回顾性分析患侧术前颞骨高分辨率CT(TB-HRCT)影像学表现,明确相关临床病史。在多平面重建图像上观察SSD位置并测量最大长度,是否伴有乙状窦憩室、颈静脉球高位及乳突导静脉畸形,并统计学分析SSD与病程关系。结果 13例研究对象均为女性,平均(34.31±11.56)岁,PT病程4个月~10年,平均(4.44±3.28)年,右侧11例,左侧2例,乙状窦憩室8例。患侧SSD长度平均为(5.32±2.28)mm,均位于横窦-乙状窦交界区前外侧壁。多因素分析SSD主要由病程决定(P=0.0070.05)。SSD长度与PT病程具有明显相关性(r=0.825,P=0.0010.05)。观察者间测量SSD长度一致性良好。结论本研究表明SSD可能具有进展性,相关PT病程越长,SSD长度可能越大。通过TB-HRCT可以充分显示SSD位置并准确、可重复测量其长度,对术前指导具有重要意义。     

引起搏动性耳鸣的乙状窦沟骨板缺损的CT评价

正摘要目的分析导致搏动性耳鸣的乙状窦沟骨板缺损的CT动脉成像(CTA)及CT静脉成像(CTV)特征。方法收集30例经乙状窦沟骨板缺损重建术治愈的搏动性耳鸣病人作为研究组,60例无症状病人作为对照组。通过CTA及CTV     

搏动性耳鸣的CT与MRI影像分析

目的：对比搏动性耳鸣的高分辨率 CT(HRCT)与 MRI CE 三维扰相梯度回波序列(three-dimensional spoiled gradient echo sequences,3D-SPGR)的影像学表现,评价其在诊断搏动性耳鸣(PT)中的应用价值。方法在已确诊的 PT 患者中选择同时行颞骨 HRCT 及 MRI CE 3D-SPGR 的15例,回顾性分析该15例 PT 患者的影像学资料,将 CT 与 MRI 检查结果对照分析,并总结2种检查方法对 PT 病因的显示。结果在15例患者中,8例9侧乙状窦异常,包括乙状窦憩室4侧,乙状窦裸露5侧;8侧伴有优势乙状窦;8例患者显示10侧颈静脉球高位;4例显示5侧粗大乳突导静脉;1例双侧半规管裂;1例鼓室球瘤;1例小血管压迫蜗神经。结论MRI CE 3D-SPGR 检查能准确地显示颅底部动、静脉血管的异常,骨结构的破坏及骨质的缺损需颞骨 HRCT 确诊,而 HRCT 在显示粗大的乳突导静脉以及小血管压迫蜗神经上逊色于 MRI CE 3D-SPGR。     

慢性中耳乳突炎伴鼓室骨壁损害的HRCT特征及临床价值探讨

目的 探讨慢性中耳乳突炎损害鼓室壁的HRCT特征及其临床价值.方法 对28例32耳慢性中耳乳突炎的影像资料进行回顾性分析.结果 （1）鼓室盖异常8耳占25%,其中骨质疏松2耳,骨壁菲薄1耳,骨壁缺损5耳 （2）颈动脉管异常6耳占18.7%,其中骨质疏松2耳,骨质硬化3耳,骨壁缺损1耳 （3）颈静脉孔壁异常5耳占15.6%,其中骨质疏松2耳,骨壁菲薄1耳,骨壁缺损2耳 （4）乙状窦骨壁异常13耳占40.6%,其中乙状窦骨壁缺损3耳,乳突窦骨壁破坏10耳,听小骨缺损、移位5耳 （5）骨迷路异常7耳占21.8%,其中鼓岬缺损1耳,前庭窗模糊1耳,蜗窗缺损2耳,面神经管缺损2耳,外半规管缺损1耳 （6）鼓膜异常21耳占65.6%,其中鼓膜缺损7耳,鼓膜增厚7耳,鼓膜内陷5耳,外耳道骨质破坏2耳.结论 运用HRCT扫描横断位和冠状位相结合,除能显示慢性中耳乳突炎病变征象外,还能确定其鼓室各壁的骨质损害部位、程度及与周围结构的关系,对手术处理具有重要意义.     

搏动性耳鸣的CT和DSA

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。     

双源CT静脉造影对上矢状窦旁脑膜瘤显微手术的价值探讨

目的 探讨脑双源CT静脉造影(CTV)显示上矢状窦旁脑膜瘤与上矢状窦关系、显示中央沟静脉和代偿回流静脉情况,从而为神经外科制定手术方案提供重要信息.方法 32例上矢状窦旁脑膜瘤患者行脑CTV检查,在工作站重建三维图像,术前判断肿瘤与静脉窦关系、显示中央沟静脉和代偿回流静脉并与术中情况对照.结果 根据CTV显示的窦腔狭窄程度,将上矢状窦旁脑膜瘤分为三型:Ⅰ型,瘤体与一侧静脉窦壁外层附着,静脉窦壁正常或轻度受压,窦腔通畅;Ⅱ型,肿瘤沿静脉窦壁生长,窦壁不规则增厚,窦腔变窄但尚通畅;Ⅲ型,瘤体长人静脉窦内或跨越生长,静脉窦腔内形成充盈缺损,窦腔闭塞,同时有静脉侧支循环建立.本组Ⅰ型8例,Ⅱ型15例,Ⅲ型9例.术中观察到代偿扩张的浅静脉以及肿瘤与中央沟静脉、上矢状窦的关系均与CTV结果相符.本组无术后严重神经功能受损和死亡病例.结论 上矢状窦旁脑膜瘤患者术前行CTV检查可以明确肿瘤部位、矢状窦阻塞程度及引流静脉代偿情况,为手术人路的选择及手术方案的制定提供重要信息,在全切肿瘤的同时减少并发症的发生,提高患者的生活质量.     

颅内静脉窦血栓形成的早期MRI诊断及病理基础

目的:研究颅内静脉窦血栓形成(CVST)的MR表现及其病理基础,旨在提高早期诊断水平.方法:回顾分析经临床和影像学方法确诊的11例CVST患者.MR检查技术包括平扫、增强扫描及MRV;其中4例行CT平扫检查;3例行DSA检查.结果:11例CVST累及上矢状窦5例,横窦1例,乙状窦1例,直窦1例,上矢状窦及横窦及乙状窦联合受累2例,横窦及乙状窦联合受累1例.CVST的直接征象:急性期血栓3例,T1 WI呈等信号或等高混杂信号,T2 WI呈低信号,周围可见稍高信号的环,为增厚的硬膜;亚急性期血栓8例,T1 WI及T2 WI均以高信号为主.增强扫描受累静脉窦可见空"三角"征或"充盈缺损"征.MRV可显示受累静脉窦不显影或者充盈缺损形成.CVST的继发脑损害包括脑肿胀、出血及梗死等.结论:磁共振检查对CVST的早期诊断具有重要价值.对于T2 WI呈低信号的急性期血栓,应仔细观察围是否有较高信号的环形改变,进一步行增强扫描结合MRV检查可作出早期准确的诊断.     

脑静脉窦血栓形成的MRI诊断(附15例分析)

目的 :探讨MRI对脑静脉窦血栓 (VST)的诊断价值。方法 :回顾性分析 15例VST患者的完整临床和影像学资料。全部行MR检查 ,其中 9例行增强扫描 ,8例行脑静脉MRA检查 ;12例曾行CT检查 ,其中 4例行增强扫描。结果 :上矢状窦受累 12例合并横窦血栓 11例 ,窦汇 7例、乙状窦 6例、下矢状窦、直窦受累 6例 ,海绵窦受累 1例。血栓在T1WI上均呈等、高不均匀信号 ,并出现脑组织肿胀 ,脑沟变浅 ,脑回模糊 ,在T2 WI上信号因发病时间不同而有所不同 ,8例T2 WI脑实质无异常信号 ,7例T2 WI脑实质出现异常信号。增强扫描 9例全部出现静脉异常强化。MRA表现为受累静脉窦信号较淡、边缘模糊且不规则的血流信号或血流信号完全消失。 12例CT检查中 2例见“空delta征” ,4例表现为梗塞、出血等不典型改变。结论 :MRI是诊断VST的首选检查方法 ,并对VST的预后评价有重要意义     

Pulsatile tinnitus associated with a laterally placed sigmoid sinus.

We describe a case of subjective pulsatile tinnitus associated with a laterally placed sigmoid sinus. CT showed an enhancing eroding through the medial wall of the right mastoid. Two-dimensional time-of-flight MR angiography and conventional cerebral angiography revealed the tortuous and laterally deviated sinus.     

耳鸣患者颞骨异常的CT及MRI研究

目的 采用HRCT和MRI对耳鸣患者颞骨进行检查,探讨其异常发生率及最佳扫描方案.方法 回顾性分析1015例耳鸣患者的HRCT和MRI资料.搏动性耳鸣145例,142例行HRCT,7例行MRI,其中4例同时行HRCT和MRI,仅行平扫HRCT者67例,仅行增强HRCT者71例.非搏动性耳鸣870例,650例行HRCT,267例行MRI,其中47例同时行HRCT和MRI,仅行平扫HRCT者598例,仅行增强HRCT者5例.分析颞骨异常阳性率及构成比,比较不同影像学检查方法和序列对颞骨异常的显示效果.采用χ2检验对数据进行组间分析.结果 1015例中显示病变者767例(75.57%).常见颞骨异常发生率分别为:颈静脉窝高位414例(40.79%);乙状窦异常387例(38.13%);中耳乳突炎148例(14.58%);中颅窝低位70例(6.90%).平扫HRCT对颈静脉窝高位显示阳性率最高(365/665,54.89%);增强HRCT对乙状窦异常显示的阳性率最高(56/76,73.68%).在搏动性耳鸣患者中,乙状窦异常发生率最高(96/145,66.21%),且其发生率明显高于非搏动性耳鸣患者(291/870,33.45%;χ2=56.537,P＜0.01).真稳态进动快速成像(FIESTA)序列显示内耳道内血管袢影最佳(42/42,100%).结论 颈静脉窝高位和乙状窦异常是耳鸣患者最常见的颢骨影像异常.搏动性耳鸣首选增强HRCT,非搏动性耳鸣首选平扫HRCT,内耳道内血管显示首选MR FIESTA序列.

Abstract：

Objective To study high resolution CT (HRCT) and MRI findings of temporal bone anomaly in patients with tinnitus and identify the optimal examination method in the detection of the anomaly. Methods The HRCT and MRI data were analyzed retrospectively in 1015 patients including 145 patients with pulsatile tinnitus (PT) and 870 patients with nonpulsatile tinnitus (NPT). The positive rates of HRCT and MRI in the identification of temporal bone anomaly were analyzed and the efficiency of various examination methods was compared in revealing the anomaly. Data were tested by Chi-square test analysis. Results Among 1015 patients, anomaly was seen in 767 cases (75.57%). High jugular bulb was found in 414 patients, accounting for 40. 79%. Sigmoid sinus anomaly was detected in 387 patients (38. 13%), while otitis media was found in 148 cases (14. 58%), and low middle cranial fossa in 70 cases (6. 90%). The positive rate of HRCT in the detection of high jugular bulb was 54. 89% (365/665), which was significantly higher than those of other methods (P ＜ 0. 05). The positive rate of enhanced HRCT in showing sigmoid sinus anomaly was 73.68% (56/76), which was significantly higher than those of other methods(P ＜0. 05). Sigmoid sinus anomaly was the most frequent finding in patients with PT, accounting for 66. 21% (96/145). The incidence of sigmoid sinus anomaly was higher in PT than in NPT (291/870,33.45% ;χ2 =56. 537 ,P ＜0. 01). The fast imaging employing steady-state acquisition (FIESTA) sequence was the best examination method in displaying the vessel within the internal auditory canal (42/42,100%).Conclusions High jugular bulb and sigmoid sinus anomaly were the most frequent abnormal findings of temporal bone in patients with tinnitus. Enhanced HRCT was the choice of modality in patients with PT.Plain HRCT was recommended for NPT. FIESTA sequence was the best in the evaluation of the vessel within the internal auditory canal.     

Postoperative Imaging Findings following Sigmoid Sinus Wall Reconstruction for Pulse Synchronous Tinnitus

BACKGROUND AND PURPOSE:Transmastoid sigmoid sinus wall reconstruction is a surgical technique increasingly used for the treatment of pulsatile tinnitus arising from sigmoid sinus wall anomalies. The imaging appearance of the temporal bone following this procedure has not been well-characterized. The purpose of this study was to evaluate the postoperative imaging appearance in a group of patients who underwent this procedure.MATERIALS AND METHODS:The medical records of 40 consecutive patients who underwent transmastoid sigmoid sinus wall reconstruction were reviewed. Thirteen of 40 patients underwent postoperative imaging. Nineteen CT and 7 MR imaging examinations were assessed for the characteristics of the materials used for reconstruction, the impact of these on the adjacent sigmoid sinus, and complications.RESULTS:Tinnitus resolved in 38 of 40 patients. Nine patients were imaged postoperatively for suspected complications, including dural sinus thrombosis, facial swelling, and wound drainage. Two patients underwent imaging for persistent tinnitus, and 2, for development of tinnitus on the side contralateral to the side of surgery. The materials used for reconstruction (NeuroAlloderm, HydroSet, bone pate) demonstrated characteristic imaging appearances and could be consistently identified. In 5 of 13 patients, there was extrinsic compression of the sigmoid sinus by graft material. Dural sinus thrombosis occurred in 2 patients.CONCLUSIONS:The imaging findings following sigmoid sinus wall repair are characteristic. Graft materials may result in extrinsic compression of the sigmoid sinus, and this finding may be confused with dural venous thrombosis. Awareness of the imaging characteristics of the graft materials used enables this differentiation.

Tinnitus may be categorized as subjective, when it originates in either the peripheral or central auditory system and is perceived only by the patient, or objective, when it arises from a mechanical somatosound.¹ Pulsatile, or pulse synchronous, tinnitus (PST) usually arises from the abnormal self-perception of one''s vascular flow. PST is a potentially disabling symptom, which may profoundly impact daily functioning.² Although PST can arise from a number of venous and arterial abnormalities,^2,3 venous PST accounts for most cases encountered in clinical practice.⁴It is increasingly recognized that sigmoid sinus wall anomalies, which include thinning and dehiscence of the sigmoid sinus plate with or without an associated diverticulum, are a frequently encountered and surgically correctable cause of PST.^5–7 Both open surgical and endovascular interventions have proved successful in the amelioration of PST in such patients.^8–10 Sigmoid sinus wall reconstruction (SSWR) is increasingly being performed via an extraluminal, transmastoid approach.¹¹ The goal of the procedure is to bridge the bony dehiscence and reconstruct the wall of the sinus, thereby eliminating audible turbulence and interrupting the transmission of mural vibrations via the mastoid air cells. The purpose of this study was to describe the imaging findings in patients who have undergone SSWR and to evaluate the imaging characteristics of complications arising from this procedure.     

28例中耳副神经节瘤影像学分析

目的 分析和评价中耳副神经节瘤的临床和影像学表现.方法 回顾性分析28例经手术病理证实的中耳副神经节瘤的临床及影像学表现.其中20例行高分辨率CT(HRCT)检查,5例行CT增强扫描,27例行MRI检查,22例行DSA检查.结果 28例患者中,男16例,女12例,发病年龄14～73岁,平均37.8岁.临床主要表现为搏动...     

CT arteriography and venography in pulsatile tinnitus: preliminary results

BACKGROUND AND PURPOSE: Pulsatile tinnitus (PT), a common disorder, can be caused by a variety of otologic and vascular lesions. Various imaging modalities, including CT, MR imaging and angiography, and conventional angiography, have been used in the assessment of PT. Ideally, a single imaging study to evaluate for the largest variety of etiologies would be optimal. In our study, we examine the potential for CT arteriography and venography (CTA/V) in the evaluation of PT. METHODS: Sixteen patients with PT were prospectively evaluated by an otolaryngologist, had a normal otologic examination, and were referred for a CTA/V. All examinations were performed on a 16-section multidetector CT. The carotid bifurcations, internal carotid artery course, transverse and sigmoid sinuses, jugular foramen, internal jugular vein, sella turcica, and temporal bones were evaluated. RESULTS: Seven of the 16 patients had lesions on CTA/V that could account for their PT. Examples of pathologic conditions in the series included a significantly dominant venous system, a venous diverticulum with stricture, and a transverse sinus stenosis. CONCLUSIONS: Preliminary findings indicate that CTA/V can be a valuable imaging tool in the assessment of PT. With this technique, arterial, venous, middle, and inner ear causes of PT can be excluded.     

CT和MR血管造影在颅内静脉畸形诊断中的应用

目的：评价CT、MR血管造影在诊断颅内静脉畸形中的价值与限度。材料和方法：5例经DSA证实的颅内静脉畸形病例,男2例,女3例,平均年龄37岁（10-66岁）,幕上1例,幕下4例。分别在动脉期（CTA）和静脉期（CTV）扫描采样,运用SSD和MIP进行重建,全部病例行MRA、MRV检查,4例做了增强前后MRV检查。结果：CTA显示所有病灶,但没有显示颅内静脉畸形的“海蛇头“,即引流静脉影像特征,而CTV不仅显示病灶,而且还显示了引流静脉“海蛇头“影像特征;MRV显示5例病灶和其特征性的“海蛇头“影像特征,MRA没有一例显示病灶的“海蛇头“表现,4例增强前后MRV没有明显差异。结论：MRV和静脉期的CT血管造影（CTV）是诊断和随访颅内静脉畸形的有效方法,优于动脉期的CT血管造影（CTA）,MRA可作筛选之用,排除其他血管性病变。     

Evaluation of Anterior Ethmoidal Artery by 320-Slice CT Angiography with Comparison to Three-Dimensional Spin Digital Subtraction Angiography: Initial Experiences

Objective

To explore the usefulness of 320-slice CT angiography (CTA) for evaluating the course of the anterior ethmoidal artery (AEA) and its relationship with adjacent structures by using three-dimensional (3D) spin digital subtraction angiography (DSA) as standard reference.

Materials and Methods

From December 2008 to December 2010, 32 patients with cerebrovascular disease, who underwent both cranial 3D spin DSA and 320-slice CTA within a 30 day period from each other, were retrospectively reviewed. AEA course in ethmoid was analyzed in DSA and CTA. In addition, adjacent bony landmarks (bony notch in medial orbital wall, anterior ethmoidal canal, and anterior ethmoidal sulcus) were evaluated with CTA using the MPR technique oriented along the axial, coronal and oblique coronal planes in all patients. The dose length product (DLP) for CTA and the dose-area product (DAP) for 3D spin DSA were recorded. Effective dose (ED) was calculated.

Results

The entire course of the AEA was seen in all 32 cases (100%) with 3D spine DSA and in 29 of 32 cases (90.1%) with 320-slice CTA, with no significant difference (p = 0.24). In three cases where AEA was not visualized on 320-slice CTA, two were due to the dominant posterior ethmoidal artery, while the remaining case was due to diminutive AEA. On MPR images of 320-slice CT, a bony notch in the orbital medial walls was detected in all cases (100%, 64 of 64); anterior ethmoidal canal was seen in 28 of 64 cases (43.8%), and the anterior ethmoidal sulcus was seen in 63 of 64 cases (98.4%). The mean effective dose in CTA was 0.6 ± 0.25 mSv, which was significantly lower than for 3D spin DSA (1.3 ± 0.01 mSv) (p < 0.001).

Conclusion

320-slice CTA has a similar detection rate for AEA to that of 3D spin DSA; however, it is noninvasive, and may be preferentially used for the evaluation of AEA and its adjacent bony variations and pathologic changes in preoperative patients with paranasal sinus diseases.     

Venous thromboembolism: additional diagnostic value and radiation dose of pelvic CT venography in patients with suspected pulmonary embolism

Purpose

To assess the additional diagnostic value of indirect CT venography (CTV) of the pelvis and upper thighs performed after pulmonary CT angiography (CTA) for the diagnosis of venous thromboembolism (VTE).

Materials and methods

In a retrospective analysis, the radiology information system entries between January 2003 and December 2007 were searched for patients who received pulmonary CTA and additional CTV of the pelvis and upper thighs. Of those patients, the radiology reports were reviewed for the diagnosis of pulmonary embolism (PE) and deep venous thrombosis (DVT) in the pelvic veins and veins of the upper thighs. In cases with an isolated pelvic thrombosis at CTV (i.e. which only had a thrombosis in the pelvic veins but not in the veins of the upper thigh) ultrasound reports were reviewed for the presence of DVT of the legs. The estimated radiation dose was calculated for pulmonary CTA and for CTV of the pelvis.

Results

In the defined period 3670 patients were referred to our institution for exclusion of PE. Of those, 642 patients (353 men, 289 women; mean age, 65 ± 15 years, age range 18–98 years) underwent combined pulmonary CTA and CTV. Among them, PE was found in 227 patients (35.4%). In patients without PE CTV was negative in all cases. In patients with PE, CTV demonstrated pelvic thrombosis in 24 patients (3.7%) and thrombosis of the upper thighs in 43 patients (6.6%). Of those patients 14 (2.1%) had DVT in the pelvis and upper thighs. In 10 patients (1.5%) CTV showed an isolated pelvic thrombosis. Of those patients ultrasound reports were available in 7 patients, which revealed DVT of the leg veins in 5 cases (1%). Thus, the estimated prevalence of isolated pelvic thrombosis detected only by pelvic CTV ranges between 1–5/642 patients (0.1–0.7%). Radiation dose ranges between 4.8 and 9.7 mSv for additional CTV of the pelvis.

Conclusion

CTV of the pelvis performed after pulmonary CTA is of neglectable additional diagnostic value for the detection of VTE, because the additional radiation dose is high and isolated pelvic DVT is very rare. Venous imaging of the legs (preferably by radiation-free ultrasound) is sufficient for the diagnosis of underlying DVT in patients with suspected PE.     

中耳胆脂瘤的HRCT诊断

目的 :探讨中耳胆脂瘤HRCT特征、诊断及鉴别诊断。材料和方法 :回顾性分析 66例中耳胆脂瘤患者术前临床和HRCT检查资料 ,并与手术病理结果对照。结果 :66例中耳胆脂瘤HRCT表现为鼓室 /鼓窦内团块状软组织影和骨质改变 ,包括听骨硬化、移位、破坏 ,盾板破坏及中耳腔扩大 ,有的还伴有乙状窦、天盖、面神经管及水平半规管的破坏。结论 :依据中耳腔内软组织影的分布、形态及骨质改变等特点 ,中耳胆脂瘤可通过HRCT做出诊断和鉴别诊断。