中国临床医学影像杂志2023，Vol.34Issue(12)：845-850,6.DOI:10.12117∕jccmi.2023.12.003
静脉源性搏动性耳鸣随访期间症状改变的血流动力学机制探究
Exploring the hemodynamic mechanisms of symptomatic changes in venous pulsatile tinnitus during follow-up
摘要
Abstract
Objective:The aim of this study is to clarify the change of symptom severity over time in venous pulsatile tinnitus(VPT)patients and to explore predictive factors for tinnitus severity changes in non-surgical intervention VPT patients.Method:This study included 59 unilateral VPT patients and 51 healthy volunteers.4D flow MRI was used to evaluate the hemodynamic status of the transverse and sigmoid sinuses,and temporal bone HRCT was used to evaluate the size of sigmoid sinus wall dehiscence(SSWD).Design baseline,1 month and 6 months tinnitus handicap inventory follow-up.Analyze the impact of baseline hemodynamic characteristics and the size of SSWD on the severity of symptoms in patients during follow-up and its predictive significance.Result:Compared with healthy volunteers,VPT patients had higher peak velocity(P<0.001),wall shear stress(P<0.001)and energy loss(P<0.001).During the follow-up period,most VPT patients experienced worsening symptoms in 1 month(P=0.001)and 6 months(P<0.001).The stepwise linear regression model showed that the baseline peak velocity can be used as independent risk factor for the severity of tinnitus in both 1 month follow-up(β=0.545,P<0.001)and 6 months follow-up(β=0.699,P<0.001).Logistic model displayed SSWD(β=0.179,P=0.018)and peak velocity(β=0.030,P= 0.040)can be used as an independent predictor of symptom exacerbation in VPT patients.Conclusion:Most non-surgical intervention VPT patients have poor prognosis.Higher peak velocity and SSWD can predict the worsening of tinnitus symptoms in VPT patients after 6 months.The hemodynamic parameters provided by 4D flow MRI can be used as predictive factors of dynamic changes in tinnitus symptoms in VPT patients provides a powerful reference for clinical treatment decision-making.关键词
耳鸣/体层摄影术,X线计算机/磁共振成像Key words
Tinnitus/Tomography,X-Ray Computed/Magnetic Resonance Imaging分类
医药卫生引用本文复制引用
吕珂,王慧颖,柴超,徐开旭,夏爽..静脉源性搏动性耳鸣随访期间症状改变的血流动力学机制探究[J].中国临床医学影像杂志,2023,34(12):845-850,6.基金项目
国家自然科学基金项目(82171916) （82171916）
天津市卫生健康科技项目重点学科专项(TJWJ2022XK019). （TJWJ2022XK019）
