| Citation: | TIAN S，WANG Z W，CAO X P，et al. Identification of pulsatile tinnitus and visualization of high pathogenic regions based on CT images[J]. Journal of Beijing University of Aeronautics and Astronautics，2025，51（2）：625-632 （in Chinese） doi: 10.13700/j.bh.1001-5965.2023.0074
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The diagnosis of pulsatile tinnitus (PT) typically relies on medical imaging tests. However, due to the wide range of possible causes, there is still a lack of universally accepted diagnostic criteria with a clearly defined mechanism. This study aims to propose a neural network model for high-accuracy PT identification based on CT images of PT patients and non-PT individuals, as well as automatically label the high pathogenic regions to assist in diagnosis. Transfer learning based on the ResNet-v1-50 model was employed to identify PT using horizontal cross-sections of the middle temporal bone in the bone window. The high-weight regions for identification were labeled using the grad-CAM method. These regions, along with related anatomical structures, were statistically analyzed across three databases: large sections (entire cranium), medium sections (bilateral temporal bones), and small sections (right-side temporal bone), allowing for the gradual refinement of the area of interest and increased resolution of high-weight regions in classification. The best identification, which achieved 100% accuracy in the test set, came from the medium area that included both temporal bones. The high-weight regions identified in PT were concentrated in either bilateral or unilateral temporal bones, primarily involving the temporal bone air cells, tympanic antrum, sigmoid sinus cortical plate, and superior tympanum. The occurrence of PT is closely associated with temporal bone and nearby bone structures. PT patients have a probability of structural abnormalities in either bilateral or contralateral temporal bones, which are different from those without tinnitus. Specifically, bone structures including temporal bone air cells, tympanic antrum, sigmoid sinus cortical plate and tympanic cavity have a high probability of containing the primary pathogenic factors for PT. These imaging-based conclusions align with previous biomechanical findings, further corroborating the understanding of PT etiology.
| [1] |
吴敏曼, 周家璇, 尹文艳, 等. 耳鸣的治疗进展[J]. 现代中西医结合杂志, 2009, 18(18): 2215-2217. doi: 10.3969/j.issn.1008-8849.2009.18.088
WU M M, ZHOU J X, YIN W Y, et al. Progress in treatment of tinnitus[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2009, 18(18): 2215-2217(in Chinese). doi: 10.3969/j.issn.1008-8849.2009.18.088
|
| [2] |
KRISHNAN A, MATTOX D E, FOUNTAIN A J, et al. CT arteriography and venography in pulsatile tinnitus: Preliminary results[J]. AJNR American Journal of Neuroradiology, 2006, 27(8): 1635-1638.
|
| [3] |
WEISSMAN J L, HIRSCH B E. Imaging of tinnitus: A review[J]. Radiology, 2000, 216(2): 342-349. doi: 10.1148/radiology.216.2.r00au45342
|
| [4] |
PEGGE S A H, STEENS S C A, KUNST H P M, et al. Pulsatile tinnitus: differential diagnosis and radiological work-up[J]. Current Radiology Reports, 2017, 5(1): 5. doi: 10.1007/s40134-017-0199-7
|
| [5] |
KIM S H, AN G S, CHOI I, et al. Pre-treatment objective diagnosis and post-treatment outcome evaluation in patients with vascular pulsatile tinnitus using transcanal recording and spectro-temporal analysis[J]. PLoS One, 2016, 11(6): e0157722. doi: 10.1371/journal.pone.0157722
|
| [6] |
SONG J J, AN G S, CHOI I, et al. Objectification and differential diagnosis of vascular pulsatile tinnitus by transcanal sound recording and spectrotemporal analysis: a preliminary study[J]. Otology & Neurotology, 2016, 37(6): 613-620.
|
| [7] |
EISENMAN D J. Sinus wall reconstruction for sigmoid sinus diverticulum and dehiscence: a standardized surgical procedure for a range of radiographic findings[J]. Otology and Neurotology, 2011, 32(7): 1116-1119. doi: 10.1097/MAO.0b013e31822a1c7d
|
| [8] |
LIU W J, LIU Z H, ZHENG N, et al. Temporal bone pneumatization and pulsatile tinnitus caused by sigmoid sinus diverticulum and/or dehiscence[J]. BioMed Research International, 2015, 2015(1): 970613.
|
| [9] |
TOPAL O, ERBEK S S, ERBEK S, et al. Subjective pulsatile tinnitus associated with extensive pneumatization of temporal bone[J]. European Archives of Oto-Rhino-Laryngology, 2008, 265(1): 123-125.
|
| [10] |
TÜZ M, DOĞRU H, YEŞILDAĞ A. Subjective pulsatile tinnitus associated with extensive pneumatization of temporal bone[J]. Auris Nasus Larynx, 2003, 30(2): 183-185. doi: 10.1016/S0385-8146(03)00002-6
|
| [11] |
WARD B K, CAREY J P, MINOR L B. Superior canal dehiscence syndrome: lessons from the first 20 years[J]. Frontiers in Neurology, 2017, 8: 177. doi: 10.3389/fneur.2017.00177
|
| [12] |
LIU X, DU Z H, HAN T, et al. Quantitative analysis of blood flow in cerebral venous sinus with stenosis by patient-specific CFD modeling[J]. IEEE Access, 2018, 7: 3848-3854.
|
| [13] |
IBRAHIM A U, OZSOZ M, SERTE S, et al. Pneumonia classification using deep learning from chest X-ray images during COVID-19[J]. Cognitive Computation, 2021, 16(4): 1-13.
|
| [14] |
EL ASNAOUI K, CHAWKI Y, IDRI A. Automated methods for detection and classification pneumonia based on X-ray images using deep learning[M]//Yassine M, Youssef B, Mamoun A, et al. Artificial Intelligence and Blockchain for Future Cybersecurity Applications. Berlin: Springer, 2021: 257-284.
|
| [15] |
刘飞, 张俊然, 杨豪. 基于深度学习的医学图像识别研究进展[J]. 中国生物医学工程学报, 2018, 37(1): 86-94. doi: 10.3969/j.issn.0258-8021.2018.01.012
LIU F, ZHANG J R, YANG H. Research progress of medical image recognition based on deep learning[J]. Chinese Journal of Biomedical Engineering, 2018, 37(1): 86-94(in Chinese). doi: 10.3969/j.issn.0258-8021.2018.01.012
|
| [16] |
BHATTACHARYYA A, BHAIK D, KUMAR S, et al. A deep learning based approach for automatic detection of COVID-19 cases using chest X-ray images[J]. Biomedical Signal Processing and Control, 2022, 71: 103182. doi: 10.1016/j.bspc.2021.103182
|
| [17] |
JIANG H Y, XU J, SHI R J, et al. A multi-label deep learning model with interpretable grad-CAM for diabetic retinopathy classification[C]// IEEE Engineering in Medicine and Biology Society Annual International Conference. Pisscataway: IEEE Press, 2020: 1560-1563.
|
| [18] |
TIAN S, FAN X Y, WANG Y W, et al. An in vitro experimental study on the relationship between pulsatile tinnitus and the dehiscence/thinness of sigmoid sinus cortical plate[J]. Journal of Biomechanics, 2019, 84: 197-203. doi: 10.1016/j.jbiomech.2018.12.049
|
| [19] |
TIAN S, WANG L Z, YANG J M, et al. Sigmoid sinus cortical plate dehiscence induces pulsatile tinnitus through amplifying sigmoid sinus venous sound[J]. Journal of Biomechanics, 2017, 52: 68-73. doi: 10.1016/j.jbiomech.2016.12.012
|
| [20] |
TIAN S, FAN X Y, WANG Y W, et al. A study on relationship between pulsatile tinnitus and temporal bone pneumatization grade[J]. Computer Methods in Biomechanics and Biomedical Engineering, 2019, 22(7): 788-796. doi: 10.1080/10255842.2019.1593386
|
| [21] |
HOFMANN E, BEHR R, NEUMANN-HAEFELIN T, et al. Pulsatile tinnitus: imaging and differential diagnosis[J]. Deutsches Arzteblatt International, 2013, 110(26): 451-458.
|
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