颈静脉孔区肿瘤类型及其CT和MRI特征分析  

Analysis of tumor types and CT and MRI features in jugular foramen area

作　　者：邬小平[1] 张巧莹 裴彩侠 张宏[2] 马鸣岳[2] 高明[2] 杨想春[2] 郭华[2] WU Xiao-ping;ZHANG Qiao-ying;PEI Cai-xia;ZHANG Hong;MA Ming-yue;GAO Ming;YANG Xiang-chun;GUO Hua(Xi'an Central Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710003,Shaanxi,China)

机构地区：[1]西安交通大学附属西安市中心医院放射科,陕西西安710003 [2]西安交通大学附属西安市中心医院,陕西西安710003

出　　处：《川北医学院学报》2021年第9期1181-1186,共6页Journal of North Sichuan Medical College

基　　金：陕西省重点研发计划(2020SF-139);陕西省自然科学基础研究项目(重点项目2021JZ-58)。

摘　　要：目的:探讨颈静脉孔区不同肿瘤类型及其CT和MR特征。方法:回顾性分析45例经手术病理证实的颈静脉孔区肿瘤的临床和CT/MRI特点,包括病灶周围骨质破坏、病灶密度与MRI平扫及增强的信号特点,及病灶的位置、大小和边界。结果:(1)病变类型:副神经节瘤18例、神经鞘瘤10例、内淋巴囊肿瘤5例、神经纤维瘤3例、脑膜瘤3例、软骨肉瘤2例、横纹肌肉瘤2例、浆细胞瘤1例及骨化性纤维粘液样瘤1例。统计结果显示,颈静脉孔区常见肿瘤为副神经节瘤、神经源性肿瘤(包括神经纤维瘤及神经鞘瘤)及内淋巴囊肿瘤。(2)常见肿瘤的CT与MRI特点:①副神经节瘤位于颈静脉孔的血管部,可见典型的"胡椒盐征"及骨质破坏;②神经鞘瘤及神经纤维瘤位于颈静脉孔前内侧部,压迫性骨质吸收,边缘较清晰;③脑膜瘤常呈宽基底紧贴颅骨,可见典型的"脑膜尾征";④内淋巴囊肿瘤位于岩骨后缘,T1WI可伴有高信号;⑤软骨肉瘤以岩枕裂为中心,伴钙化。结论:颈静脉孔区不同类型肿瘤有一定特征性,CT与MRI结合应用有助于术前鉴别诊断。Objective:To investigate different tumor types and their CT and MR features in jugular foramen area.Methods:The clinical and CT/MRI features of 45 cases with jugular foramen tumors confirmed by surgical pathology were analyzed retrospectively.The observation indexes included bone destruction around the lesion,lesion density,signal intensity of plain and enhanced MRI,as well as the location,size and boundary of the lesion.Results:Lesion typesincluded paraganglioma in 18 cases,schwannoma in 10 cases,endolymphatic sac tumor in 5 cases,neurofibroma in 3 cases,meningioma in 3 cases,chondrosarcoma in 2 cases,rhabdomyosarcoma in 2 case,plasmacytoma in 1 case and ossifying fibromyxoma in 1 case.The statistical results showed that the common tumors in jugular foramen area were paraganglioma,neurogenic tumors(including neurofibroma and schwannoma)and endolymphatic cystoma.CT and MRI features of common tumors in jugular foramen areawereasfollows:(1)paraganglioma was located in the vascular part of jugular foramen,with typical"Pepper Salt sign"and bone destruction.(2)Schwannoma and neurofibroma were located in the anteromedial part of jugular foramen,with compressive bone resorption and clear margin.(3)Meningiomas showed a wide base close to the skull,with a typical"meningeal tail sign".(4)Endolymphatic sac tumor was located at the posterior edge of petrosal bone,and T1WI could be accompanied by high signal intensity.(5)Chondrosarcoma centered on petrooccipital fissure with calcification.Conclusion:Different types of tumors in jugular foramen area have certain characteristics.The combination of CT and MRI is helpful for preoperative differential diagnosis.

关 键 词：颈静脉孔 肿瘤 磁共振成像 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学] R445.2[医药卫生—放射医学]