颈静脉球瘤术前血管内治疗的应用价值  

Clinical application of preoperative endovascular management for jugular paraganglioma

作　　者：俞炬明[1] 范国平[1] 钟伟兴[1] 张永平[1] 彭海腾[1] 程永德[2] 

机构地区：[1]上海交通大学医学院附属新华医院放射科,200092 [2]上海解放军第85医院,南京军区介入放射中心

出　　处：《介入放射学杂志》2009年第7期484-487,共4页Journal of Interventional Radiology

摘　　要：目的评价颈静脉球瘤术前造影及栓塞的应用价值。方法14例颈静脉球瘤经CT和MRI及五官科详细检查评价,所有患者于术前行双侧颈动脉及患侧椎动脉造影,栓塞供血动脉及瘤巢,7例患者行患侧颈内动脉球囊阻断试验以了解Willis环功能,栓塞后48h手术切除颈静脉球瘤。结果14例颈静脉球瘤术前造影和供血动脉及瘤巢栓塞均获成功,肿瘤切除术中出血明显减少,7例颈动脉球囊阻断试验均获成功,3例术中施行颈内动脉结扎术,术后及随访期未出现新的神经系统症状或体征。结论颈静脉球瘤术前行供血动脉和瘤巢栓塞及颈内动脉球囊阻断试验安全可靠,可作为常规的术前准备。Objective To investigate the clinical value of preoperative angiography and embolization managements for jugular paraganglioma. Methods Fourteen patients with jugular paraganglioma were carefully evaluated with CT, MRI and clinical ENT exams. Bilateral carotid and affected-side vertebral angiography together with embolization of the feeding arteries and tumor nidi were performed in all 14 patients before surgery. Internal carotid artery balloon occlusive test was employed to check the function of Willis＇ circle in 7 patients. The tumors were excised within 48 hours after embolization. Results Preoperative angiographic and embolization procedures of jugular paraganglioma were successfully accomplished in all patients. The mean blood loss during the surgery was obviously less than usual. Of seven cases who passed the internal carotid artery balloon occlusive test,carotid artery ligation was adopted in 3. No new symptoms and signs of nervous system developed after the surgery and during the follow-up period. Conclusion The angiography and embolization of feeding-arteries and tumor nidi, and the preoperative balloon occlusive test of carotid artery performed before the surgery of jugular paraganglioma are safe and reliable, which can be regarded as a routine preoperative preparation.

关 键 词：颈静脉球瘤 栓塞 球囊阻断试验 

分 类 号：R739.91[医药卫生—肿瘤]