舌骨上咽旁间隙神经鞘瘤与颈动脉体瘤影像表现及鉴别诊断  

Imaging features and differential diagnosis of schwannoma in suprahyoid parapharyngeal space and carotid body tumor

作　　者：王建华[1] 周广超[2] 李惠[3] 袁永丰[1] 曾亮[1] 

机构地区：[1]南京中医药大学附属医院放射科,江苏南京210029 [2]南京医科大学附属口腔医院放射科,江苏南京210029 [3]南京中医药大学附属医院病理科,江苏南京210029

出　　处：《中国临床研究》2017年第11期1491-1494,共4页Chinese Journal of Clinical Research

摘　　要：目的探讨颈部舌骨上咽旁间隙的神经鞘瘤和颈动脉体瘤的特征性影像学表现,旨在提高对该病变的术前诊断准确率。方法回顾性分析2014年7月至2016年11月经手术病理证实的8例咽旁间隙神经鞘瘤和4例颈动脉体瘤患者的临床影像学资料,分析两者的影像学特点,为临床鉴别诊断提供参考。结果 (1)神经鞘瘤8例,CT示病灶均境界清晰、光整;其中4例瘤体使颈内、外动脉分离,4例使颈内动脉与颈内静脉分离,3例颈内外动脉向外移位;神经鞘瘤位置多变。3例CT平扫信号呈均匀稍低密度影,6例CT增强呈轻-中度渐进性强化。3例MRI显示,T1WI呈稍低信号,T2WI呈混杂稍高-高信号,其中2例增强扫描表现为明显强化,病灶内未见流空血管信号,周围未见明显增粗供血血管。(2)颈动脉体瘤4例,均有浅分叶征存在;瘤体均骑跨于颈动脉分叉处,颈内、外动脉分离移位明显,呈"抱球征"或"高脚杯征"。平扫CT呈均匀软组织密度影;3例CT增强明显均匀强化,1例不均匀显著强化。结论根据咽旁间隙神经鞘瘤和颈动脉体瘤的病变位置、形态、强化方式及与邻近血管的关系,CT和MRI检查可以做出准确鉴别。Objective To explore the characteristic manifestations of CT and MRI of schwannoma in suprahyoid parapharyngeal space and carotid body tumor to improve the accuracy of preoperative diagnosis of the disease. Methods Retrospective analysis was carried out on clinical imaging data of 8 patients with parapharyngeal space schwannoma and 4 patients with carotid body tumor proved by operation and pathology from July 2014 to November 2016. The imaging features of the two tumors were analyzed to provide reference for clinical differential diagnosis. Results Imaging finding of schwannoma： （1）The CT imaging in 8 cases showed that the boundary of lesion was clear and smooth. The location of sehwannoma was variable in which separation of internal carotid artery and external carotid artery and separation of internal carotid artery and internal jugular vein by tumor were respectively seen in 4 cases, and outward displacement of internal carotid artery by tumor was seen in 3 cases. Plain scan signal of CT in 3 cases presented homogeneous slightly low density shadow. The enhancement imaging of CT in 6 cases presented mild to moderate progressive enhancement. （ 2 ） MRI in 3 cases showed that T1WI presented slightly low signal, and T2WI presented mixed slightly high to high signal. MRI enhanced scan in 2 cases showed that the lesions were markedly enhanced, and there were no signal voids of vessel in lesions and obviously thickening blood-supply vessels around the lesions. CT finding of carotid body tumor in 4 case ： （ 1 ） There was superficial lobulation sign in all 4 cases. （2） Tumors strode cross the carotid bifurcation, and the separation and displacement of internal carotid artery and external carotid artery were obvious with ＂ball holding＂ sign,＂ hold ball＂ sign or ＂goblet＂ sign. （3）Plain scan of CT showed that lesion presented homogeneous soft tissue density shadow, and CT Enhancement scan showed obvious homogeneous obvious enhancement in 3 cases and inhomogeneous obvious enhancementin 1 c

关 键 词：咽旁间隙 神经鞘瘤 颈动脉体瘤 CT 磁共振成像 鉴别诊断 

分 类 号：R445[医药卫生—影像医学与核医学]