![]() Diseases of the Brain, Head and Neck, Spine 2020–2023: Diagnostic Imaging. In: Hodler J, Kubik-Huch RA, von Schulthess GK, editors. Evaluation of Tinnitus and Hearing Loss in the Adult. Pulsatile Tinnitus: Differential Diagnosis and Radiological Work-Up. On the left a typical case of intracranial hypertension with enlarged Meckel cave (left image, white arrowheads), prominent subarachnoid space around the optic nerve (middle image, white arrow) and bilateral venous sinus stenosis (right image, black arrowheads). It is therefore advised to perform MRV or CTV in a patient with pulsatile tinnitus and suspicion of IIH. The exact pathophysiology of IIH is unknown but can develop in patients with a history of dural sinus thrombosis.ĭural sinus stenosis or compression can also be observed in IHH. Idiopathic intracranial hypertension (IIH), which predominantly affects young obese women, may cause pulsatile tinnitus, although IIH is primarily characterized by symptoms of headache and blurred vision due to increased cerebrospinal fluid pressure. stenosis and occlusion.ĭuring ultrasound, manual compression can be performed to investigate the influence of compression on tinnitus. The role of duplex ultrasound in the diagnostic work-up of pulsatile tinnitus is limited, although duplex ultrasound is an effective screening tool for the evaluation of vessel wall pathology of the carotid arteries, e.g. The role of conventional angiography (DSA) in the diagnostic work-up of pulsatile tinnitus has been minimized, and should be reserved for the indication to rule out vascular pathology in case MRI/MRA and CT/(4D-)CTA have not revealed the cause of pulsatile tinnitus. Multi-detector CTA or CT venography (CTV) of the head and neck region can be performed for the evaluation of vascular pathology.ĭynamic CTA, also referred to as 4D-CTA, is a technique that combines the non-invasive nature of CTA with the dynamic acquisition of digital subtraction angiography (DSA). You can click on the table for a large view.įor screening for underlying pathology and for the evaluation of a possible soft tissue mass or intracranial pathology, initial evaluation with MRI and MR angiography (MRA) is recommended with reported high diagnostic accuracy.įor the evaluation of osseous pathology of the temporal bone, a limited scanning range of thin-sliced (submillimetric) CT is sufficient. How to Differentiate Carotid Obstructions.TI-RADS - Thyroid Imaging Reporting and Data System.Head Neck tumors - When to think of malignancy.Esophagus II: Strictures, Acute syndromes, Neoplasms and Vascular impressions.Esophagus I: anatomy, rings, inflammation.Vascular Anomalies of Aorta, Pulmonary and Systemic vessels.Contrast-enhanced MRA of peripheral vessels.Ischemic and non-ischemic cardiomyopathy.Coronary Artery Disease-Reporting and Data System 2.0.Bi-RADS for Mammography and Ultrasound 2013.Transvaginal Ultrasound for Non-Gynaecological Conditions. ![]() Acute Abdomen in Gynaecology - Ultrasound.Appendicitis - Pitfalls in US and CT diagnosis. ![]()
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