鼻咽部纤维血管瘤血管造影及术前超选择栓塞治疗  

Angiography and Preoperative Superselective Embolization of Nasopharyngeal Angiofibroma

作　　者：金春贤[1] 黄文鑫[2] 

机构地区：[1]浙江省丽水市中心医院放射科,浙江丽水323000 [2]浙江大学医学院附属邵逸夫医院放射科

出　　处：《实用放射学杂志》2007年第7期953-956,共4页Journal of Practical Radiology

摘　　要：目的探讨鼻咽部纤维血管瘤术前超选择栓塞的临床价值方法14例经CT和MRI诊断并为手术病理证实的鼻咽部纤维血管瘤患者,术前全部行双侧颈内外动脉及椎动脉血管造影肿瘤颈外系统供血动脉术前使用100～300μm明胶海绵颗粒或聚乙烯醇(PVA)颗粒超选择性栓塞治疗,栓塞后1～3d行手术切除结果14例患者,颌内动脉分支供血9例,颌内动脉和咽升动脉分支供血4例,颌内动脉、咽升动脉和颈内动脉分支供血1例所有患者颈外动脉供血分支微导管超选择性栓塞均获得成功栓塞后,8例肿瘤染色完全消失,6例肿瘤染色大部分消失手术全切率92.8%(13/14),手术平均出血约420m,l手术时间平均150min所有患者栓塞后均未发生严重并发症结论使用微导管术前血管内超选择栓塞鼻咽部纤维血管瘤。Objective To study the clinical value of preoperative superselective embolization of nasopharyngeal angiofibroma. Methods 14 patients with nasopharyngeal angiofibroma diagnosed by CT and MRI,and proved surgically and pathologically were included in this study. Angiography of bilateral external carotid artery and internal carotid artery as well as vertebral artery was performed in all cases. The external carotid arterial blood supply of tumors were superselectively embolized with 100 - 300 μm particles of gelfoam or polyvinyl alcohol （ PVA ） . Surgical resection was performed post - embolization 1 to 3 days. Results The main feeding vessels of tumors were the internal maxillary artery in 9 patients, the internal maxillary artery and ascending pharyngeal artery in 4 patients, the internal maxillary artery, ascending pharyngeal artery and the branches of internal carotid artery in one patient. Preoperative endovascular embolization of the branches of external carotid artery with microcatheter was achieved in all patients. After embolization, tumor stains disappeared completely in 8 patients and partially in 6 patients. The rate of total resection was 92.8% （ 13/14）. The mean amount of haemorrhage during operation was 420 ml and the mean operation duration was 150 min. No major complications were relevant to embolization occurred. Conclusion Preoperative intravascular embolization of nasopharyngeal angiofibroma with microcatheter is a safe and effective method.

关 键 词：鼻咽部 纤维血管瘤 血管造影术 介入放射学 

分 类 号：R739.63[医药卫生—肿瘤] R814.43[医药卫生—临床医学]