MR imaging and MR angiography in the evaluation of pulsatile tinnitus.
OBJECTIVE
1) To evaluate the scope of imaging findings seen with spin-echo MR and MR angiography (MRA) in patients with pulsatile tinnitus; 2) to determine whether MRA adds additional imaging information (to that provided by spin-echo MR) necessary for determining the cause of pulsatile tinnitus; and 3) to suggest MR and MRA imaging techniques for evaluation of patients with pulsatile tinnitus.


METHODS
Forty-nine patients with pulsatile tinnitus were evaluated with MR and MRA. Seventeen of these patients had conventional angiography.


RESULTS
Vascular lesions or paraganglioma were demonstrated in 28 patients. Of these 28 lesions, the majority were seen best (46%) or only (36%) on MRA. The spectrum of lesions detected included dural arteriovenous fistula (nine), extracranial arteriovenous fistula (three), paraganglioma (five), jugular bulb variants (three), aberrant internal carotid artery (one), internal carotid artery stenosis (one), tortuous internal carotid artery (one), carotid dissection with pseudoaneurysm (one), stenosis of the transverse sinus (two), and arteriovenous malformation (two).


CONCLUSIONS
MRA, in conjunction with spin-echo imaging, markedly enhances the ability of MR to diagnose the lesions responsible for pulsatile tinnitus.
Dietz
R R
RR
Department of Radiology, University of Utah Medical Center, Salt Lake City 84132.
Davis
W L
WL
Harnsberger
H R
HR
Jacobs
J M
JM
Blatter
D D
DD
D000293:Adolescent; D000328:Adult; D000368:Aged; D001164:Arteriovenous Fistula / Q000150:complications / Q000175:diagnosis; D001165:Arteriovenous Malformations / Q000150:complications / Q000175:diagnosis; D002340:Carotid Artery Diseases / Q000150:complications / Q000175:diagnosis; D002345:Carotid Body Tumor / Q000150:complications / Q000175:diagnosis; D002533:Cerebral Angiography; D002648:Child; D003937:Diagnosis, Differential; D004423:Ear / Q000098:blood supply*; D004428:Ear Neoplasms / Q000150:complications* / Q000175:diagnosis; D004432:Ear, Middle / Q000098:blood supply; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000150:complications / Q000175:diagnosis; D011673:Pulsatile Flow / Q000502:physiology*; D014012:Tinnitus / Q000209:etiology*; D014652:Vascular Diseases / Q000150:complications* / Q000175:diagnosis