超声在颈动脉体瘤及颈部神经鞘瘤定量分析与鉴别诊断中的价值  

The Value of Ultrasound in Quantitative Analysis and Differential Diagnosis of Carotid Body Tumor and Cervical Schwannoma

作　　者：李志强[1] 王艺桦 付颖[1] 崔立刚[1] Li Zhiqiang;WangYihua;FuYing;Cui Ligang(Department of Ultrasound Medicine,Peking University Third Hospital,Beijing 100191,China;Department of Ultrasound,Affiliated Hospital of North China University of Science and Technology,Tangshan,Hebei 063000,China)

机构地区：[1]北京大学第三医院超声医学科,北京市100191 [2]华北理工大学附属医院超声科,河北省唐山市063000

出　　处：《中国超声医学杂志》2024年第3期252-256,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 评估超声对颈动脉体瘤及颈部神经鞘瘤的定量分析与鉴别诊断价值。方法 回顾性分析病理诊断明确的颈部血管鞘病变共86例,其中颈动脉体瘤67例、神经鞘瘤19例。颈动脉体瘤根据术中分型分为A和B两组:A组ShamblinⅠ型(1例)和ShamblinⅡ型(10例),共11例,B组ShamblinⅢ型,56例;C组为神经鞘瘤19例。定量分析比较不同病灶的临床特征和超声表现。结果 3组患者的性别、年龄、临床表现差异无统计学意义,颈动脉体瘤B组入侵颅底的比例更高。3组病灶均边界清晰,以低回声为主,差异无统计学意义(P>0.05)。3组间是否囊性变、最大径、包绕颈动脉情况、相对颈动脉位置、颈动脉分叉夹角是否增大、超声血流分级差异有统计学意义(P<0.05)。颈动脉体瘤超声分型与术中分型高度相关,随着颈动脉体瘤病灶的增大,侵入颅底可能性增大。结论 超声可以对颈动脉体瘤及颈部神经鞘瘤进行定量分析和鉴别诊断,并可对颈动脉体瘤进行准确分型,为临床提供可靠的影像学信息,有助于治疗方案的选择与确定,具有重要的临床应用价值。Objective To evaluate the quantitative analysis and differential diagnostic value of ultrasound in carotid body tumor and cervical schwannoma.Methods A retrospective analysis was conducted on 86 cases of cervical vascular sheath lesions with clear pathological diagnosis,including 67 cases of carotid body tumor and 19 cases of schwannoma.Carotid body tumor were divided into two groups based on intraoperative classification:Group A had 11 cases,Shamblin Ⅰ(1 case) and 10 cases of Shamblin Ⅱ while Group B had 56 cases of Shamblin Ⅲ;Group C consisted of 19 cases of schwannoma.Quantitative analysis and comparison of clinical features and ultrasound manifestations of different lesions were performed.Results There was no statistically significant difference in gender,age,and clinical manifestations among the three groups.The proportion of lesions invading the skull base in group B of carotid body tumor was higher.Lesions of all three groups had clear boundaries and were mainly hypoechoic,with no statistically significant difference(P>0.05).There were statistically significant differences among the three groups in terms of cystic changes,maximum diameter,circumcision of the carotid artery,relative position of the carotid artery,increased angle of carotid bifurcation,and ultrasound blood flow grading(P<0.05).The ultrasound classification of carotid body tumor is highly correlated with intraoperative classification.As the lesion of carotid body tumor increases,the possibility of invading the skull base increases.Conclusions Ultrasound can provide quantitative analysis and differential diagnosis of carotid body tumor and cervical schwannoma,and accurately classify carotid body tumor types,which provides reliable imaging information for clinical practice,helps to select and determine treatment plans,and has important clinical application value.

关 键 词：颈动脉体瘤 颈部神经鞘瘤 彩色多普勒超声 定量分析 

分 类 号：R445.1[医药卫生—影像医学与核医学] R739.4[医药卫生—诊断学]