Bony reconstructions from CTA thus can show SSWA such as diverticulum and wall dehiscence due to bony contour abnormalities [27]. However, 1 study reported a cause of PT being found only in 68% to 72% of patients with PT despite an extensive workup with CTA, MRI, and ultrasound (US) [12]. Fibromuscular dysplasia of the carotids, atherosclerotic disease, vascular dissection, and carotid aneurysms in the neck can also cause PT, which can be accurately diagnosed by CTA head and neck [1,23,28,46,49]. Slight modification from usual CTA bolus timing can allow for a balanced phase examination facilitating detection of both arterial and venous etiologies of PT in the head and neck. Therefore, it is the imaging modality of choice in patients with PT without a suspected retrotympanic lesion because it can show both arterial and venous pathologies in the head, skull base, and neck, in addition to the bony details of the temporal bone. Temporal bone anatomy is also well seen on thin bone window reconstructions, which cannot be assessed on MRA/MRI. Bony reconstructions from CTA thus can show SSWA such as diverticulum and wall dehiscence due to bony contour abnormalities [27]. However, 1 study reported a cause of PT being found only in 68% to 72% of patients with PT despite an extensive workup with CTA, MRI, and US [12]. CTA head does not cover the neck and therefore will not be able to detect the vascular abnormalities in the neck that can cause PT. CTV Head With IV Contrast CTV can readily show various venous causes of PT such as transverse sinus stenosis and SSWA such as dehiscence and diverticulum. Transverse sinus stenosis, sigmoid sinus diverticulum, and sigmoid sinus dehiscence have been proposed as potential causes for PT [50]. Thin-section bone window reconstructions from the CTV are used to detect wall dehiscence, whereas diverticulum is seen on both CTV and bone window reconstruction images.
Tinnitus. Bony reconstructions from CTA thus can show SSWA such as diverticulum and wall dehiscence due to bony contour abnormalities [27]. However, 1 study reported a cause of PT being found only in 68% to 72% of patients with PT despite an extensive workup with CTA, MRI, and ultrasound (US) [12]. Fibromuscular dysplasia of the carotids, atherosclerotic disease, vascular dissection, and carotid aneurysms in the neck can also cause PT, which can be accurately diagnosed by CTA head and neck [1,23,28,46,49]. Slight modification from usual CTA bolus timing can allow for a balanced phase examination facilitating detection of both arterial and venous etiologies of PT in the head and neck. Therefore, it is the imaging modality of choice in patients with PT without a suspected retrotympanic lesion because it can show both arterial and venous pathologies in the head, skull base, and neck, in addition to the bony details of the temporal bone. Temporal bone anatomy is also well seen on thin bone window reconstructions, which cannot be assessed on MRA/MRI. Bony reconstructions from CTA thus can show SSWA such as diverticulum and wall dehiscence due to bony contour abnormalities [27]. However, 1 study reported a cause of PT being found only in 68% to 72% of patients with PT despite an extensive workup with CTA, MRI, and US [12]. CTA head does not cover the neck and therefore will not be able to detect the vascular abnormalities in the neck that can cause PT. CTV Head With IV Contrast CTV can readily show various venous causes of PT such as transverse sinus stenosis and SSWA such as dehiscence and diverticulum. Transverse sinus stenosis, sigmoid sinus diverticulum, and sigmoid sinus dehiscence have been proposed as potential causes for PT [50]. Thin-section bone window reconstructions from the CTV are used to detect wall dehiscence, whereas diverticulum is seen on both CTV and bone window reconstruction images.