颈交感神经鞘瘤CT表现与手术对照研究  

CT features of Schwannomas of the cervical sympathetic nerve correlated with surgical findings

作　　者：刘斌[1] 江育玲[1] 任基浩[2] 

机构地区：[1]郴州市第一人民医院耳鼻咽喉科,湖南郴州423000 [2]中南大学湘雅二医院耳鼻咽喉科,湖南长沙410011

出　　处：《山东大学耳鼻喉眼学报》2009年第4期18-20,共3页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨CT在术前诊断颈交感神经鞘瘤(SSN)的价值。方法回顾性分析16例经手术和病理检查证实为颈交感神经鞘瘤患者的CT资料。分别对病变部位、肿块大小、边界、强化作出判断。重点分析在CT轴面上SSN与颈总、内动脉及颈内静脉的位置关系。对照研究病变的定位与手术所见。结果肿块均呈膨胀性生长,周围结构呈受压推移改变。10例表现为内密度不均,不均匀强化。6例表现为低密度区内散在不规则结节状、云团状或烟雾状高密度强化影。CT增强扫描示10例次颈总动脉移位于肿瘤的外半周的前半侧;16例次颈内动脉被推移于肿瘤的外半周的偏后侧。14例显示颈内静脉受压、变形并移位于肿瘤的外半周,颈内静脉皆移位于颈总(内)动脉的外后;动静脉相互靠近或分离不超过90°。手术中所见血管移位关系与此相一致。结论CT仍能较准确地反映颈交感神经颈总(内)动脉及颈内静脉等原有的解剖定位关系。根据典型血管移位关系对本病作出术前诊断具有一定的价值。Objective To investigate the value of CT in the diagnosis of schwannomas of the cervical sympathetic nerve （SSN） corrleated with surgical findings. Method Sixteen consecutive patients with schwannomns of the cervical sympathetic nerve, proven by surgery and pathology, were referred to computed tomography axial scanning. The CT findings for the location of masses, size, margin, contrast enhancement, and the rules of displacement of the common carotid artery, internal carotid artery and internal jugular vein were evaluated. Also the locations, characteristics of the lesions and rules of displacement of the common carotid artery, internal carotid artery and internal jugular vein were described with surgical correlation. Results 10 SSNs were located at the level of the common carotid bifurcation with the common carotid artery abutting against and displacing the lateral periphery of the tumor, and 16 SSNs with the internal carotid artery abutting against and displacing the lateral periphery of the tumor. In 14 SSNs with enhanced CT, the internal jugular vein also abutted against and displaced the lateral periphery of the tumor. All the anatomical positional relationships among the common carotid artery, internal carotid artery and internal jugular vein with the cervical sympathetic nerve were proved by operation. Conclusion CT axial scan can accurately reflect the anatomical positional relationships among the common carotid artery, internal carotid artery and internal jugular vein with the cervical sympathetic nerve.

关 键 词：神经鞘瘤 神经节 交感 体层摄影术 X线计算机 

分 类 号：R739.91[医药卫生—肿瘤]