Application of CT venography in the assessment of internal jugular vein stenosis decompression surgery for refractory tinnitus
Objective To investigate the clinical application of CT venography(CTV)in the assessment of therapeutic effect of internal jugular vein stenosis decompression surgery for recurrent tinnitus.Methods Sixteen tinnitus patients undergoing internal jugular vein stenosis decompression surgery were recruited from September of 2020 to December of 2022.CTV image quality and the internal jugular vein stenosis were evaluated with subjective and objective indices,and objective indices included CT values,signal to noise ratio(SNR)and contrast to noise ratio(CNR).The subjective assessments were evaluated by two radiologists blindly with image quality scores systems(1 to 4 scores,with the higher score indicating higher image quality).Kappa analysis was used to analyze the consistency of the two radiologists.CTV was used to follow up the recovery of the stenotic vein lumen 6 months after surgery(the lumen circumference widened by＞50％).Results The objective index of image quality for sixteen internal jugular vein stenosis patients before and after surgery were as follows:CT value(277.5±20.0 HU vs.280.0±19.7 HU),SNR(9.1±3.0 vs.8.4±3.0),CNR(4.1±2.7 vs.4.2±2.7),while the subjective assessments were 0.82 and 0.81 with kappa analysis,including 14 patients graded as 4 points,2 patients as 3 points,whereas 12 patients as 4 points,with 4 patients as 3 points.Three cases of bilateral and 13 cases of unilateral internal jugular vein stenosis were found,including 4 in the left side and 9 in the right side.The predilection site of stenosis lied in the transverse process of atlas,with 9 patients for hyperosteogeny of transverse process of transverse process of atlas,and 7 patients for vein travelling between the transverse process of atlas and styloid process.After surgery,12 patients showed internal jugular veins dilated,with 6 patients had alleviation,while 4 patients reported no recovery of internal vein stenosis for the adhesion of local scar tissues.Conclusions CTV demonstrates clinical applications in the diagnosis and therapeutic effects for internal jugular vein stenosis.The bony structure of transverse process of atlas is the anatomical basis of predilection factor.
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