The temporal bone is a paired component of the cranium, which is distinguished by its complex relief and non-standard shape. It consists of three segments, the dysfunction of which leads to irreversible health consequences. The temporal bone is necessary to protect the nerve nodes, the auditory system and a large artery, and regulates the functioning of the vestibular apparatus. If there are problems in the characteristic zone, a computed tomography scan of the temporal bones is required.
General information about the procedure
CT scan of the temporal bone is a non-invasive diagnostic method that allows you to evaluate the structural and functional elements of the suspected focus of pathology. When using computed tomography, X-rays are sent to the temporal bone, which captures cross-sectional images. The position of the bone structure appears on the screen, the state of neighboring systems and tissues, and suspected mutagenic zones (malignant tumors) are determined.
This diagnostic method can be carried out simultaneously with MRI to clarify the diagnosis, adjust medical prescriptions, allow you to determine the exact treatment regimen, and increase the patient’s chances of recovery. Temple injury is one of the most common pathologies in which clinical examination is difficult. CT and MRI using sensitive equipment shows oncological processes, inflammatory diseases, abscesses and infectious lesions, extensive damage to the vascular walls and abnormalities in the development of bone structures.
Carrying out MRI in such a clinical picture becomes auxiliary against the background of the main diagnostic method - CT of the temporal bones. This is explained by the fact that the first procedure accurately visualizes soft tissues on the screen, which contain hydrogen atoms and liquid. Since this formula is somewhat different from bone structures, MRI is considered an ineffective method in diagnosing bones, and it is advisable to use computed tomography as an alternative. If there is a suspicion of the presence of malignant tumors, an MRI cannot be avoided.
Indications for the procedure
CT scan of the temporal bones is shown in the following clinical pictures:
The doctor prescribes an examination for the purpose of effective treatment, but it is also possible to perform a CT scan for the purpose of effective prevention.
Contraindications to the procedure
CT scans of the temporal bones, like other non-invasive diagnostic methods, have their limitations, the violation of which leads to a sharp deterioration in general well-being and a relapse of the main diagnosis. Thus, restrictions apply to the following pathologies and characteristics of the body:
If a CT scan of the temporal bones is indicated during breastfeeding, the child needs to be switched to artificial formula for a short time. As reported by numerous studies, the contrast agent is excreted in breast milk and penetrates the placental barrier.
In most clinical situations, doctors recommend a CT scan using an iodine-based contrast agent. This is necessary to get a clear picture on the screen and improves the visualization of bone structures. If even after such preparatory measures there are still doubts about the diagnosis, you must agree to additional MRI.
Preparatory measures and procedure
CT in certain clinical pictures is performed using a contrast agent, which requires preliminary preparation of the clinical patient. 5-6 hours before the procedure, be sure to stop eating, and 1-2 hours before the procedure, it is advisable not to drink at all. It is also recommended to refrain from bad habits and avoid the penetration of toxic and poisonous substances into the body. When a CT scan of the temporal bones is performed without the use of a contrast agent, there is no need for preparatory measures.
The description of the procedure makes it clear that the patient is not in for a difficult test. The procedure lasts 3–7 minutes and requires immobility of the clinical patient. The patient is asked to lie down on a special table, which moves into the internal space of the tomograph. A special ring rotates in a circle above your head, while the couch moves forward. The communication in the tomograph is two-way, so if you feel discomfort, you can report your feelings to the medical personnel who are watching what is happening through the glass.
If the patient moves during a CT scan of the temporal bones, the image on the tomograph screen will be blurry and unclear. In this case, it is difficult to determine the final diagnosis; further diagnosis is required, and repeated use of this non-invasive method is possible.
Before performing a CT scan of the temporal bones, you need to find out the indications from the doctor, and also ask what the cost of the examination is. On average, the price range varies between 2 - 3 thousand rubles, but it is important to remember that the procedure with contrast will cost much more (but the result is more accurate, the conclusion is informative).
Benefits of the procedure
Computed tomography of any bone structure is highly sensitive and guarantees detection of the pathological process at an early stage.
If MRI studies soft tissues in detail, CT is more appropriate when diagnosing bone structures and durable biological materials.
The method eliminates side effects if you strictly adhere to all recommendations. Anomalies occur only if intolerance to iodine, from which the contrast agent is made, predominates in the body.
You can receive a conclusion immediately after the procedure and go with it to the attending physician for a reliable diagnosis and an adequate treatment regimen.
If we compare the cost of the procedure with the price of magnetic resonance imaging, it is an order of magnitude lower and is available to all patients.
Many patients are captivated by the speed of the session, so they do not have to remain in a motionless position for a long time and suffer mentally.
Before injecting a contrast agent into a vein, the doctor performs allergy tests, which eliminates the risk of a skin rash and the discomfort that accompanies it.
The list of contraindications is limited, and some clinical symptoms (pregnancy, lactation) are temporary.
If the doctor recommended a CT scan of the temporal bones, then you should first find out what such a diagnosis provides, what the results influence, and what the consequences are for the organic resource in a particular case. After such explanations, it is recommended to agree to the examination and not delay visiting the clinic. Perhaps such a delay could cost the patient physical activity and life.
Computed tomography of the temporal bones is performed for adults and children to identify pathological changes and structural anomalies. CT does not require special preparation, and contraindications are minimal.
The temporal bones perform a number of important functions. Arteries, nerve fibers, and a movable upper jaw are attached to them. They serve as a natural protection for the inner ear and the complex vestibular system. Any damage to the temporal bones is fraught with serious consequences, for example, problems with hearing, vision, brain function, and the functioning of blood vessels. For a quick and accurate diagnosis of this area, a CT scan of the temporal bones is prescribed.
The procedure is painless and takes a minimum of time - 5-10 minutes without the use of contrast and up to 30 minutes with the introduction of contrast.
During the examination, a minimal level of x-ray exposure is used, however, repeat tomography can be done at least after 3 weeks.
Adults and children are referred for a CT scan by either an ENT or maxillofacial surgeon. Doctors may prescribe an examination if there are:
- hearing loss and vision impairment for no apparent reason;
- dizziness, pain in the temples;
- pain and discharge from the ear;
- chronic otitis;
- foreign objects in the ear;
- temporal lobe injuries;
- difficulties with mobility of the upper jaw;
- suspicion of tumor processes;
- the presence of benign cysts;
- destruction of the temporal bones or suspicion of it.
Preoperative preparation for electrode installation, as well as observation during the period after implantation, are also considered as indications for the use of a tomograph. You cannot do without CT when examining a special part of the temporal bone - the pyramid. Here are the inner and middle ear, the most important blood vessels, and nerve fibers. When examining the temporal bone in the area of the pyramid, contrast is usually used.
What can a CT scan of the temporal lobes show?
When a computed tomography scan of the temporal region is performed, the image specialist analyzes the appearance of the skull bones, the condition of the middle and inner ear, the pyramids and mastoid process, and the auditory canal. Based on the footage, the doctor can identify:
- Chronic or acute otitis media.
- Abscess.
- Development of infection.
- Otosclerosis and mastoiditis, as well as other modifications of the temporal bones.
- Presence of tumors.
- Fractures, bone cracks.
- Soft tissue injuries.
- Hemorrhages.
The structure of the pyramids of the temporal bones, the presence of neuromas and tumors, the causes of discharge from the ears, the abnormal structure - this is what tomography shows when studying this area. If there are internal injuries, the procedure will reveal areas of fresh bleeding.
Depending on the contrast or non-contrast method, CT diagnostics takes 10-30 minutes. Transcription lasts less than 1 hour.
How tomography and preparation is done
During the examination, the patient lies on a special table, which slowly slides into the active part of the device. The tomograph rotates around the head with little noise. X-rays are directed to the temporal lobes. Sometimes the specialist may ask the patient to turn their head or hold their breath. Staying still during a tomography is the main condition for obtaining clear images.
CT with contrast is prescribed to study the condition of soft tissues, identify tumors, inflammatory and infectious processes. The pyramids of the temporal bones are also examined. The coloring agent contains iodine and is administered intravenously half an hour before the procedure or during tomography after the first series of images. Sometimes a CT scan with a contrast agent may cause slight dizziness or nausea. If side effects increase, you should tell specialists about this - the tomograph is equipped with a two-way communication system.
Home preparation for the examination is very simple:
- No contrast - not required.
- With contrast, food intake is completed 6 hours before the procedure, and the last drink can be taken 2 hours before the tomography. Alcohol and smoking are excluded during the day. These measures are aimed at reducing side effects such as nausea, itching, dizziness, as well as normalizing the vascular system.
Immediately before the examination, it is necessary to remove all jewelry from the head - earrings and piercings. The doctor should know in advance about the presence of metal parts in the area where the CT scan will be performed.
Who should not do it
When examined with a tomograph, there are contraindications that either completely exclude the possibility of carrying out the procedure or impose certain restrictions on it.
Attention! Pregnancy at any stage, as well as hyperkinesis of the head, are an unconditional contraindication to CT scanning of the temples.
People who are overweight, which could damage the device, are not allowed to be examined on a tomograph. Different units have their own limit values. The most sensitive of them can withstand only 120 kg. Women with painful PMS are advised to avoid CT scanning.
If a tomography of the temples is planned for a child, then depending on his age and ability to lie still, he may be put into a state of medicated sleep.
When an examination with contrast is carried out, a number of diseases and conditions are added for which there are restrictions on the use of a tomograph:
- Renal failure, disorders of the endocrine and cardiovascular systems are contraindications depending on the severity.
- Allergy to iodine-containing contrast - an indicator may be seafood intolerance.
During breastfeeding, a woman should not feed her baby for 2 days after a CT scan so that the contrast agent is cleared from the body.
Summing up
The temporal region of the head performs a number of important functions, and damage to it can seriously impair hearing, vision, and brain function. A CT scan of the temples can quickly and accurately detect such injuries, identifying problems not only with the skeletal system, but also with soft tissues. The procedure is painless and in the case of the non-contrast method does not require special preparation. When a contrast agent is administered, there are restrictions only on the consumption of food and water before the tomography. CT scans are not done during pregnancy.
The cost of the examination starts from 2500 rubles.
, maxillofacial surgeons and otolaryngologists. Using CT scans of the temporal bones, fractures, developmental anomalies, inflammatory and infectious processes of various origins and localization (in the area of the inner and middle ear, mastoid process, etc.) are detected. The study is indicated for suspected tumors of the temporal bones. The technique makes it possible to determine the size, shape and prevalence of a neoplasm (benign or malignant), and to identify the presence of neoplasia metastases of other localizations.
CT makes it possible to assess the severity of osteosclerosis, confirm the presence and severity of destruction when purulent processes spread to bone structures, and establish the cause of discharge from the external auditory canal. Using a CT scan of the temporal bones, nearby soft tissues are examined. The procedure is carried out at the stage of preoperative preparation for installation of a cochlear implant.
Contraindications
Absolute contraindications to CT of the temporal bones are pregnancy due to the teratogenic effect of X-rays on the fetus and children under 14 years of age due to the possible negative effect of X-rays on a growing organism. As an exception, situations are considered when the procedure is necessary for health reasons (for example, severe head injury). Relative contraindications to CT are obesity (weight more than 150 kg), hyperkinesis and mental disorders accompanied by increased physical activity. CT scanning of the temporal bones with contrast is not prescribed for patients suffering from severe renal and hepatic pathology, diabetes mellitus, and diseases of the cardiovascular system. Contrast-enhanced CT is not indicated in cases of iodine intolerance.
Preparing for CT
The procedure without contrast enhancement does not require preparation. When using contrast, the patient is recommended to fast for 6 hours before the start of the CT scan. Before contrasting, a preliminary skin test is performed to determine the tolerance of iodine preparations. Nursing mothers stop feeding on the day of the study and resume it only two days later, after the contrast has been completely removed from the body.
If the skin test result is negative, a radiopaque substance is injected intravenously and waited for some time until the drug is distributed evenly in the tissues and illuminates them. Contrast can be injected 15 minutes before the CT scan or during the procedure, after a series of native images. Sometimes the administration of iodine preparations is carried out through a catheter, which can be left in the vein in case of need for continuous or repeated infusion of contrast.
Methodology
Tomography of the temporal bones takes from 5 to 30 minutes, depending on the volume of the scan; with contrast, the duration of the procedure increases. Processing scans on a computer makes it possible to obtain a 3D model of the temporal region.
The patient receives a description of the examination and printed images an hour after the scan is completed; if the x-ray doctor is heavily loaded, the time for preparing the report may increase. At the request of the patient, the scans are transferred to a digital medium or sent to an email address. The absence of changes is interpreted as the norm. If a pathology is detected, the patient contacts the attending physician with the results of the study. The specialist may prescribe an additional examination, develop an outpatient treatment plan, or issue a referral for hospitalization (planned or emergency).
MRI of the temporal bones is currently one of the fastest and at the same time highly informative methods for diagnosing this area. In case of traumatic lesions of the temporal bone, the speed of the examination is decisive. And in this regard, MRI definitely has advantages, since it does not require any preparation. The proximity of the brain to the temporal bone and the high risk of damage to it in case of injury to the temporal bone require prompt determination of the complexity of the injury in order to decide on the method of treatment and the need for surgical intervention.
The temporal bone of the skull has a complex shape and internal relief, being, in addition, the load-bearing part of the skull. The temporal bone is where the hearing aid is attached and also serves as protection for the inner ear and vestibular system. The temporal bone, connecting to the movable part of the jaw apparatus, ensures the chewing function. Finally, nerve fibers and arteries are attached to the inside of the temporal bone. Thus, the role of the temporal bone is enormous, and any injury to it leads to disruption of vital functions. Any pathology of the temporal bone invariably affects the circulatory system, the organs of vision and hearing, and the brain.
Indications
MRI of the temporal bone has enormous diagnostic value. The procedure may be prescribed in the following cases:
- Pain in the middle ear.
- Visual or hearing impairment of unknown etiology.
- Purulent discharge from the ears.
- Disorders of the jaw apparatus.
- Injuries to the temporal region.
- The need to prepare for surgery on the skull and subsequent monitoring of the results of the operation.
- Otitis and other inflammatory pathologies.
- Abscesses and infections.
- Tumors and suspected tumors.
- Degenerative phenomena.
- Problems with coordination of movements and maintaining balance.
- Disorders of the facial muscles.
- Taste disturbances.
MRI of the temporal bones allows us to identify problems such as acute and chronic otitis media, inflammation of the inner ear, injuries and fractures of the temporal bones, the presence of an infectious process in this area, otosclerosis and other degenerative pathologies.
Contraindications
MRI is not performed in the following cases:
- Pregnancy and lactation period. Pregnant women can be prescribed MRI only for health reasons, if the benefit from the diagnosis significantly outweighs the possible risk to the fetus. If breastfeeding, an MRI with contrast is not prescribed, or if an examination is necessary, the mother should stop breastfeeding for at least a day after the procedure.
- The presence of metal or electronic implants in the patient’s body, incl. dentures made of metal other than titanium.
- Renal failure is a contraindication for MRI with contrast, since in this case the normal outflow of contrast from the body is impossible, and intoxication may occur.
- The patient's weight is more than 130 kg.
- Allergy or tendency to allergic reactions.
- Severe claustrophobia - MRI in this case can be performed with the patient immersed in a medicated sleep.
Preparation
MRI does not require special preparation. The patient does not need to disrupt his usual eating and sleeping patterns, adhere to any strict diet, or refuse to take prescribed medications.
How do they do it?
The patient is placed on a couch, which is then placed in the cylindrical tunnel of the tomograph so that the patient's head is inside the tunnel. The examination lasts about 25 minutes; if contrast is used, this time increases to 40-45 minutes.
During the entire procedure, the patient must remain motionless, since the clarity of the images depends on this. If the patient experiences fear or severe pain, he may be advised to take sedatives or put him to sleep beforehand. If necessary, the patient's head can also be fixed with special rollers.
The results of the examination, with a transcript from the doctor, are usually delivered to the patient the next day. In the transcript, the doctor describes in detail the detected pathologies and gives recommendations for treatment. With the results, the patient can subsequently contact his doctor, who issued a referral for an MRI, or a specialist recommended by the diagnostician.
MRI data can also be recorded onto a CD if desired by the patient.
Using Contrast
In cases where there is a suspicion of the presence of a tumor, or it is necessary to clarify the boundaries of the pathology more clearly, an MRI with contrast may be prescribed. The contrast agent is a gadolinium-based drug that does not harm the body and is completely eliminated naturally within 24 hours.
Contrast is administered intravenously. By spreading through the bloodstream and accumulating in the affected tissues, the contrast agent promotes better visualization of problem areas.
Advantages of the method
- MRI is a non-invasive diagnostic method that allows you to avoid additional trauma to the body during the examination.
- MRI does not use radiation, so the procedure is safe even for small children.
- MRI gives a clear picture of the pathology, helping to identify the problem at an early stage. This is very important when detecting oncology, since early diagnosis can significantly improve the prognosis of treatment.
Possible risks
For all its undeniable advantages, magnetic resonance imaging is not without some risks. First of all, we are talking about examining pregnant women. The negative impact of MRI on the developing fetus has not yet been proven, however, experts associate the development of fetal pathologies with the influence of the magnetic field of the tomograph, and therefore recommend refraining from the procedure, at least in the first trimester of pregnancy.
In addition, there is a risk of an unexpected allergic reaction to the contrast agent.
Finally, patients with impaired renal function are at risk of complications from this pathology if contrast-enhanced MRI is used.
Alternatives
- Computed tomography of the temporal bones. This method is somewhat different from MRI in terms of effectiveness. The main difference is the greater sensitivity of CT to recognize bone structures. Therefore, CT and MSCT (multislice CT) have become more widespread in the diagnosis of fractures and injuries of the temporal bones, while MRI is more often used to identify tumors, vascular and soft tissue pathologies. In addition, CT has one significant drawback: the method uses radiation exposure, and therefore is not used for frequent monitoring of the patient’s condition.
- X-ray examination. This method is used only for diagnosing temporal bone fractures.
- Ultrasound. A rarely used method because it has little information content.
- PET-CT. This technique allows, in addition to identifying pathology, to also monitor functional disorders.
Price
The price of an MRI of the temporal bones in Moscow (depending on the chosen clinic) can range from 4 to 8 thousand rubles. When contrasting, the cost increases. Also, the price may be higher if the patient orders one or more additional services (recording results on disk, consultation with a specialist after diagnosis).
The price of an X-ray examination and ultrasound rarely exceeds a thousand rubles. But prices for PET-CT are invariably high and can reach 50-60 thousand rubles.
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