目的 探讨静脉性耳鸣患者蛛网膜颗粒内脑疝(brain herniation into arachnoid granulation,BHAG)对于横窦跨狭窄压力梯度(trans-stenostic pressure gradient,TPG)升高(≥ 8mm Hg)的诊断效能.方法 回顾性分析2019年11月至2023年10月于首都医科大学附属北京友谊医院住院的静脉性耳鸣患者临床及影像学资料,所有患者均行静脉窦非增强MRV(non-contrast enhanced MR venography,NCE-MRV)、全脑MPRAGE及3D-T2WI扫描,并经DSA行静脉窦测压,将患者分为A(TPG＜8 mm Hg)、B(TPG ≥ 8 mm Hg)两组.结合全脑MPRAGE及3D-T2WI的标准冠状面图像,评价是否存在BHAG.对A、B两组BHAG发生率是否存在差异进行卡方检验;计算BHAG对于诊断高TPG(≥ 8 mm Hg)特异度、灵敏度、准确度、阳性预测值及阴性预测值.结果 共73例患者符合纳排标准(男性9例,女性64例),年龄37.0(46.5-30.0)岁,其中A组(TPG＜8 mm Hg)46例,B组(TPG≥ 8 mm Hg)27例.BHAG患者共 12例(12/73,16.44％),A、B两组BHAG发生率存在统计学差异(x2值=10.96,P＜0.001).BHAG诊断高TPG(≥ 8 mmHg)的特异度为95.65％、灵敏度为37.04％、准确度为73.97％、阳性预测值为83.33％,阴性预测值为72.13％.结论 BHAG在静脉性耳鸣患者中并不罕见,可用于辅助预估有无TPG升高.
Diagnostic Efficiency of Brain Herniation into Arachnoid Granulation for High Trans-stenostic Pressure Gradient in Patients with Venous Tinnitus
Objective To explore the diagnostic efficiency of Brain herniation into arachnoid granulation(BHAG)for high Trans-stenostic pressure gradient(TPG,≥8 mm Hg)in patients with venous tinnitus.Methods Clinical and imaging data of patients with unilateral Pulsatile tinnitus(PT)admitted to Beijing Friendship Hospital,Capital Medical University from November 2019 to October 2023 were retrospectively analyzed.All patients underwent Non-contrast enhanced MR venography(NCE-MRV),whole brain MPRAGE and 3D-T2WI scanning,and venous sinus pressure was measured by DSA.Patients were divided into two groups:Group A(TPG＜8 mm Hg)and Group B(TPG ≥8 mm Hg).BHAG was evaluated in standard coronal images of whole brain MPRAGE and 3D-T2WI.Chi-square test was performed to determine whether the incidence of BHAG was different between Group A and Group B.The specificity,sensitivity,accuracy,positive predictive value and negative predictive value of BHAG were calculated for the diagnosis of high TPG(≥8 mm Hg).Results A total of 73 patients(9 males and 64 females),aged 37.0(46.5-30.0)years,met the exclusion criteria,including 46 patients in Group A(TPG＜8 mm Hg)and 27 patients in Group B(TPG ≥8 mm Hg).There were 12 patients with BHAG(12/73,16.44％),and the incidence of BHAG was significantly different between group A and group B(x2 value=10.96,P＜0.001).The specificity,sensitivity,accuracy,positive predictive value and negative predictive value of BHAG for diagnosis of high TPG(≥8 mm Hg)were 95.65％,37.04％,73.97％,83.33％and 72.13％,respectively.Conclusion BHAG is not uncommon in patients with venous tinnitus and can be used to the estimation of elevated TPG.
Venous TinnitusBrain Herniation Into Arachnoid GranulationTrans-stenostic Pressure Gradient
万方数据
维普
