摘要
目的基于CT血管造影(CTA)分析无搏动性耳鸣(PT)人群乙状窦憩室(SSD)形成的相关因素。方法回顾性分析2018年1至12月在首都医科大学附属北京友谊医院行头颈部CTA,且符合纳入标准的42例单侧SSD受检者,男19例、女23例,平均年龄27~76(61±10)岁;左侧15例,右侧27例。按照1∶2比例纳入性别、年龄、侧别匹配的84例无SSD者为对照组,平均年龄29~84(61±12)岁。分别评估乙状窦周骨壁裂缺、静脉回流优势、横窦狭窄、颈静脉球窝高位、粗大导静脉、乳突气化程度(Ⅰ~Ⅳ级)、空蝶鞍情况。比较以上因素组间发生率差异并分析SSD形成的相关因素。结果SSD组与对照组中,乙状窦周骨壁裂缺[66.7%(28/42)比19.0%(16/84)]、同侧横窦狭窄并同侧回流优势[26.2%(11/42)比4.8%(4/84)]、空蝶鞍[19.0%(8/42)比7.1%(6/84)]发生率差异有统计学意义(均P<0.05);SSD组乳突气化程度整体低于对照组,组间差异有统计学意义(P<0.05);余因素组间差异无统计学意义。Logistic回归显示乙状窦周骨壁裂缺(P<0.01,OR=6.794,95%CI:2.530~18.245),同侧横窦狭窄并同侧回流优势(P=0.001,OR=13.293,95%CI:2.841~62.194),乳突区气化程度(P<0.01,OR=0.289,95%CI:0.156~0.536)与SSD形成独立相关。结论同侧静脉回流优势并横窦狭窄、乙状窦周骨壁裂缺、乳突区气化不良可能是SSD形成的独立相关因素。
Objective To analyze the correlative factors of sigmoid sinus diverticulum(SSD)formation in individuals without pulsatile tinnitus based on computed tomography angiography(CTA).Methods A hospital-based 1∶2 matched case-control study was performed on 42 cases with unilateral SSD and 84 controls for age,gender,and side-matched in Beijing Friendship Hospital affiliated to the Capital Medical University from January 2018 to December 2018.The signs including sigmoid sinus wall dehiscence,venous outflow dominance,transverse sinus stenosis,high jugular bulb,large emissary veins,degree of mastoid pneumatization(gradeⅠ-Ⅳ)and empty sella,were detected and analyzed.Results In SSD group and control group,there were statistically significant differences in the incidence of the sigmoid sinus wall dehiscence(66.7%(28/42)vs 19.0%(16/84)),ipsilateral transverse sinus stenosis on the dominant side of venous outflow(26.2%(11/42)vs 4.8%(4/84)),and empty sellae(19.0%(8/42)vs 7.1%(6/84))(all P<0.05).The degree of mastoid pneumatization was worse in SSD group(P<0.05).After stepwise logistic regression analysis,the sigmoid sinus wall dehiscence(P<0.01,OR=6.794,95%CI 2.530-18.245),ipsilateral transverse sinus stenosis on the dominant side(P=0.001,OR=13.293,95%CI 2.841-62.194),and degree of mastoid pneumatization(P<0.01,OR=0.289,95%CI 0.156-0.536)were found independently correlated with SSD.Conclusion Sigmoid sinus wall dehiscence,ipsilateral transverse sinus stenosis on the dominant side of venous outflow and mastoid pneumatization may be some of the independent correlative factors of SSD.
作者
代驰航
赵鹏飞
孟续续
丁贺宇
李小帅
仇晓妤
赵彤
杨正汉
王振常
Dai Chihang;Zhao Pengfei;Meng Xuxu;Ding Heyu;Li Xiaoshuai;Qiu Xiaoyu;Zhao Tong;Yang Zhenghan;Wang Zhenchang(Department of Radiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Radiology,Beijing Shangdi Hospital,Beijing 100085,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2020年第9期702-705,共4页
National Medical Journal of China
基金
国家自然科学基金(61931013,81701644,61801311)
北京市自然科学基金(7172064,7182044)。
关键词
憩室
耳鸣
体层摄影术
X线计算机
乙状窦
Diverticulum
Tinnitus
Tomography
X-ray computed
Sigmoid sinus
