颈静脉球瘤的CT和MRI诊断

CT and MRI Diagnosis of Glomus Jugular Tumors

目的：探讨ＣＴ和ＭＲＩ检查在颈静脉球瘤诊断、鉴别诊断及手术径路选择中的作用与价值。材料和方法：５例经手术证实的颈静脉瘤患者，术前均行ＣＴ增强前后扫描，４例行ＭＲＩ平扫及增强后成像。分析ＣＴ和ＭＲＩ的不同表现，比较其优缺点，并介绍分型与手术径路的关系。结果：按Ｇｌａｓｓｃｏｃｋ－Ｊａｃｋｓｏｎ＇ｓ分类法，其中Ⅰ型１例，Ⅱ型１例、Ⅲ型２例、Ⅳ型１例。ＣＴ能清晰地显示颅底骨质结构的破坏程度及范围，颈静脉孔的扩大以及边缘不规则的侵蚀性破坏是颈静脉球瘤的特征性表现。ＭＲＩ能更准确地显示肿瘤的大小、与颈内动脉、颈内静脉的关系以及有无颅内侵犯、侵犯的程度。肿瘤内迂曲的流空血管及＂椒一盐＂征是颈静脉球瘤的特征性ＭＲＩ表现，结论：ＣＴ和ＭＲＩ结合，能更全面地提供临床诊断及治疗所需的信息，为治疗方法的选择提供可靠的依据。

To study the value of CT and MRI in the diagnosis, differential diagnosis of gloums jugular tumors and evaluate the value of selecting surgical approaches. Materials and Methods:5 cases (3 male, 2 female) of surgical confirmed glomus jugular tumors were examined with pre-and post-contrast CT scan, 4 of them were undergone plain and contrast-enhanced MR imaging before operation. We analysed the findings of CT and MRI, compared their advantages and the shortages,and introduced the correlation of surgical approaches with different types of glomus jugular tumors. Results: According to the Glasscock-Jackson's classification of glomus jugular tumor, one of 5 cases was classified as type Ⅰ, one as type Ⅱ, two as type Ⅲ, and one as type Ⅳ.CT can clearly demonstrate the extent and degree of bone errosion in the skull base. The enlargement and ragged erosive margings of the jugular fossa were the pathognomonic manifestations of glomus jugular tumors. MRI could more accurately delineate the size of tumor wth relation to the internal carotid artery and the internal jugular vein, and also either the intracranial extension or the extent. The serpigineous appearence of signal void in tumor and the 'salt & pepper' sign were the characteristic MR apperances of glomus jugular tumors. Conclusion: CT combined with MRI can accurately provide all the informations regarding clinical dianosis, treatment and reliable confidence for selecting therapeutic methods.