颈动脉体瘤的MRA诊断与外科治疗

MRA diagnosis and surgical treatment of carotid body tumor

目的探讨颈动脉体瘤(CBT)的影像学诊断方法和外科疗效。方法回顾性分析24例经磁共振血管造影(MRA)确诊的CBT患者的临床资料,总结MRA的临床诊断价值以及手术方式的选择和疗效。结果MRA清楚显示位于颈总动脉分叉处的实质性肿块及其与周围动脉的关系,24例CBT均为ShamblinI型和Ⅱ型;CBT单纯剥离18例,CBT联合颈外动脉切除3例,CBT联合颈内动脉切除颈外动脉转流2例,CBT联合颈内动脉切除自体静脉移植1例。全部患者术后无偏瘫及严重颅神经并发症。经1～8年随访,24例患者均无复发。结论MRA是临床诊断CBT的重要手段,可疑CBT患者术前应常规行MRA检查。外科手术是治疗CBT的最有效方法,最大限度地保留或重建颈内动脉是手术成败的关键。

Objective To discuss the imaging diagnosis and surgical treatment of carotid body tumor （CBT）. Methods A total of 24 cases with CBT admitted from 1998 to 2005 were analyzed retrospectively. The significance of magnetic resonance angiography （MRA） diagnosis and the surgical options as well as the outcomes of CBT were discussed. Results All of 24 cases were classified as Shamblin Ⅰ and Ⅱ type on the imaging of MRA, which revealed definitely a solid vascular mass and its relation with the surrounding arteries in the carotid bifurcation. Eighteen tumors were resected successfully, 3 tumors were resected combining with the lesioned external carotid artery, and 3 tumors were resected with internal carotid artery and following immediate reconstruction. No brain and severe cranial nerve impair after the operation and no reoccurrence of CBT were found during the period of eight-year＇s follow-up in all cases. Condusion MRA plays an important role in the diagnosis of CBT and should be applied routinely for the suspected before surgery. Operation is the most effective way to cure CBT, and the protection or revascularization of internal carotid artery is critical in achieving the successful surgical outcomes.