颈动脉磁共振血管成像在颈动脉体瘤诊断与治疗中的应用

Application of carotid MRA in the diagnosis and surgical treatment of carotid body tumor

目的:探讨颈动脉磁共振血管成像(CMRA)在颈动脉体瘤(CBT)临床诊断与外科治疗中的应用价值。方法:回顾性分析24例颈动脉体瘤患者的影像学资料,全组患者术前均常规行B超及磁共振血管成像检查并与外科手术及病理结果进行对照,总结分析不同检查方式的诊断符合率。结果:Doppler超声提示肿瘤内部血供丰富,对肿瘤定性方面不够准确,其中1例误诊为颈动脉瘤,诊断符合率分别为95.8%。CMRA提示24例CBT均为ShamblinI型和II型,CMRA影像学资料可清晰显示颈动脉体瘤的大小、病变累及范围及其与颈内、外动脉的关系,全组患者的CMRA影像学诊断均为术中所见以及术后病理诊断所证实,诊断符合率为100%。结论:CMRA是临床诊断CBT的重要手段,也是对该病进行临床分型和术前制订手术方案的重要依据。可疑CBT患者,术前应常规行CMRA检查。

Objective： To discuss the clinical value of carotid magnetic resonance angiography（CMRA） in the diagnosis and surgical treatment of carotid body tumor（CBT）. Methods： The imagining materials of 24 cases with CBT admitted from 1998 to 2005 were analyzed retrospectively. All patients were examined by ultrasound and carotid magnetic resonance angiography routinely before the operation, and the results were compared with that of surgeries, and the accuracy rate of the two examinations were analyzed. Results： The ultrasound showed rich in blood supply of CBT but were not accurate in judging the source of the tumor, and the accuracy rate of ultrasound was 95.8%. Meanwhile, all 24 cases were classified as Shamblin I and II type on the imagining of CMRA, which revealed definitely a solid vascular mass and its relation with the surrounding arteries in die carotid bifurcation. The diagnosis of CMRA were confirmed by surgery as well as post-operation pathological sections. The accuracy rate of diagnosis of CMRA was 100%. Conclusions： CMRA plays an important role in the diagnosis and clinical classification as well as surgical treatment of CBT. When CBT was suspected, CMRA should be examined routinely before surgery.