Radiologic features of vascular pulsatile tinnitus – suggestion of optimal diagnostic image workup modalities

Abstract

Objectives: The aim of this study was to determine the optimal diagnostic workup modalities for vascular pulsatile tinnitus through analysis of clinical and radiologic findings.

Materials and methods: A total of 49 patients diagnosed with vascular pulsatile tinnitus along with their medical records and radiologic findings were thoroughly reviewed.

Results: Of these patients, 84% had venous lesions. The jugular bulb variants (67%) were the most common venous lesions followed by sigmoid sinus variants (12%). About 88% (43/49) of these lesions were detected with computed tomography of the temporal bone (TBCT) alone and the lesions were either venous or intratemporal artery in origin. Simple manual neck compression test was 93% sensitive in predicting venous lesions. A high suspicion for venous lesion coupled with manual neck compression test and selection of the optimal imaging technique are useful for the proper evaluation of vascular pulsatile tinnitus at the initial visit.

Conclusion: Our stepwise strategy may increase the cost-effectiveness of the chosen imaging workup by reducing redundancy of multiple and simultaneous radiologic tests in patients with vascular pulsatile tinnitus.

Chinese abstract

目的：本研究的目的是通过分析临床和放射检查结果来确定血管性脉动性耳鸣的最佳诊断检查模式。

材料与方法：对49例诊断为血管性脉动性耳鸣的患者及其医疗记录和放射学检查结果进行了透彻的复审。

结果：这些病人中, 84％有静脉病变。颈静脉球变型（67％）是最常见的静脉病变, 其次是乙状结肠窦变体（12％）。大约88％（43/49）的这些病变用颞骨计算机断层扫描（TBCT）检测, 它们是静脉或颞动脉起源的。简单的手动颈部压迫检验在预测静脉病变中有93％的敏感度。静脉损伤的高度可能性加上手动颈部压迫检验以及选择最佳成像技术对于首次看病时适当评估血管性脉动性耳鸣是有用的。

结论：我们的逐步策略可以通过减少血管性脉动性耳鸣患者的多次和同时的放射学检查, 来提高所选成像诊断检查的成本效益。

Keywords:

• Tinnitus
• pulsatile
• vascular
• diagnosis

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by a research fund of the Chungnam National University (2016-1557-01).