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1、头颈部影像学-197-HEADANDNECKIMAGING颈动脉体瘤的综合影像诊断戚跃勇邹利光周宇帅杰周政梅文铭【摘要】目的:评价颈动脉体瘤(CBT)的综合影像诊断价值。方法:回顾性分析24例CBT患者超声、MSCT、MRI和DSA检查资料,其中18行MSCTA检查、16例行MRI和MRA检查。结果:超声、MSCT、MRI和DSA检查均可显示肿瘤位置、大小及形态,所有颈动脉体瘤均位于颈动脉分叉处,21例为单侧,3例为双侧,共27个瘤体,平均直径(5.0±2.3)cm,其影像学特征为瘤体位于颈总动脉分叉处并与其紧密相连,呈单发肿块,瘤体内血供
2、丰富,瘤体使颈外动脉向前内移位、颈内动脉向后外移位,颈内外动脉分叉角度明显增大,在MSCTA、MRA及DSA上呈“金杯”征。超声、MSCT、MRI和DSA的诊断准确率分别是87.5%、95.8%,100%和100%。结论:超声、CT、MRI及DSA在CBT的诊断中均有其各自的特点,临床上应根据其检查目的选择合适的检查方法。【关键词】颈动脉体瘤;体层摄影术,X线计算机;磁共振成像;数字减影血管造影中图分类号:R445文献标志码:A文章编号:1006-5741(2010)-03-0197-04ComprehensiveImagingDiagno
3、sisofCarotidBodyTumorsQIYue-yong,ZOULi-guang,ZHOUYu,SHUAIJie,ZHOUZheng,MEIWen-ming【Abstract】Purpose:Toevaluatethevalueofcombinedimagingexaminationsindiagnosisofcarotidbodytumor(CBT).Methods:Retrospectiveanalysisof24CBTcaseswithultrasonography,CT,MRIandDSAwereundergoneinour
4、study,MSCTAwasdonein18cases,MRIandMRAin16.Results:Theimagingexaminationsincludingultrasonography,CT,MRIandDSAcoulddisplaythelocation,sizeandformofthetumorwell.Alltumorswerelocatedinbifurcationofthecarotidartery;21wereunilateral(10locatedatrightneck,11locatedatleftneck);3ca
5、seswereinbilateralneck.Themeandiameterwas5.0±2.3centimeters.Theimagingfeaturesof24patientswithCBTwere:locationofthelesionwasatthebifur2cationofcarotidartery;Bloodsupplyinthetumorwasabundant;Internalandexternalcarotidarterieswereshifted;Thebifurcationofcarotidarterywasincre
6、asedandshowed“Goldcup”inCTA,MRAandDSA.Thediagnosticaccuracyofultrasonography,CT,DSAandMRwas87.5%,95.8%,100%and100%,respectively.Conclusion:ThecombinedimagingexamshavedefinitelycharacteristicvalueindiagnosingCBT.AllofthemplayimportantrolesonthediagnosisofCBT,anddifferenttec
7、hniquesarecarriedoutaccordingtothepurpose.【Keywords】Carotidbodytumor;Tomography,X-raycomputed;MRI;DSA颈动脉体瘤(carotidbodytumor,CBT)又称方法副神经节瘤(paraganglioma)或化学感受器瘤[1-3](chemodectoma),临床上较为少见。影像学检查经手术病理证实的CBT患者24例,男9例,女在其诊疗中起着重要的作用,本文收集24例经手术病15例,年龄13~57岁,平均(37.5±5.6)岁,病程2月理证实并
8、经超声、CT、MRI、DSA等影像学综合检查~12年。右侧10例,左侧11例,双侧3例。查体:肿块的CBT作一回顾性分析,以分析其各自的诊断价值。表面光滑,边界清,质较硬,水平方