磁共振成像和磁共振血管造影对颈动脉间隙肿瘤诊断价值分析  

Value of MR imaging and MR angiography in the differential diagnosis of carotid space tumour

作　　者：刘佩芳[1] 李欣[2] 鲍润贤[1] 刘经祖[3] 葛正津[3] 

机构地区：[1]天津医科大学附属肿瘤医院放射科,300060 [2]天津儿童医院放射科 [3]天津医科大学附属肿瘤医院头颈科,300060

出　　处：《中华肿瘤杂志》2004年第4期239-243,共5页Chinese Journal of Oncology

摘　　要：目的　探讨无创性磁共振成像 (MRI)和磁共振血管造影 (MRA)对颈动脉间隙肿瘤的诊断价值 ,及其对术前制定手术方案的作用。方法　对临床可疑或确诊为颈动脉间隙肿瘤的 2 6例患者进行了术前颈部MRI和MRA检查 ,观察病变的形态、边界、内部信号 ,病变与颈动脉、分支动脉和颈内静脉的关系 ,以及颈总动脉分叉角度。结果　在 2 2例经手术或活检病理证实的患者中 ,颈动脉体瘤14例 (15个 ) ,颈动脉瘤 4例 ,神经鞘瘤 3例 ,转移性低分化鳞状细胞癌 1例。另有 4例经MRI和MRA检查及临床随访证实 ,3例为一侧较对侧明显增粗的颈总动脉 ,1例为迂曲走行的颈总动脉。MRI结合MRA检查对本组颈动脉体瘤和颈动脉瘤术前诊断均正确 ,并且MRI、MRA原始像及MRA三维重建像可提供准确的肿瘤与颈动脉及分支的关系。结论　无创性MRI和MRA检查对颈动脉间隙肿瘤 ,特别对颈动脉体瘤和颈动脉瘤的诊断优于其他检查方法 ,可以替代以往所必须进行的有创性颈动脉造影。Objective To determine the imaging features of magnetic resonance imaging (MRI) and 2D time of flight (TOF) MR angiography (MRA) and study the value in the differential diagnosis and surgical planning for carotid space tumors. Methods Twenty-six patients with suspected pulsatile carotid space mass were imaged by MRI and 2D TOF MRA from 1996 to 2003. Its characteristic findings were analyzed for lesion shape,margin,signal intensity,angle of common carotid bifurcation,and the relationship between the great vessels and carotid space mass. Results Of the 26 patients,22 were verified histopathologically,including 15 carotid body tumors (1 patient had bilateral carotid body tumors),4 carotid artery aneurysms,3 schwannomas,and 1 metastatic carcinoma. The rest four patients had clinical pseudomasses proved by MRI and MRA as considerable dilated or tortuous carotid artery as compared with the contralateral one. Combined MRI and MRA assessment of carotid body tumors and carotid artery aneurysm yielded an accuracy of 100%. It was also revealed that the anatomy shown on the MRI and axial MRA source images was consistent with that found by surgery. Conclusion MRI in combination with MRA is considered as non-invasive imaging technique for the evaluation of carotid space tumor showing superiority to other modalities in the differential diagnosis between vascular versus non-vascular tumours. This method may take the place of traumatic carotid angiography

关 键 词：磁共振成像 磁共振血管造影 颈动脉间隙肿瘤 影像学诊断 三维重建 形态学表现 

分 类 号：R739.91[医药卫生—肿瘤] R730.4[医药卫生—临床医学]