头颈部假性颈动脉瘤的影像学诊断

Imaging diagnosis of the carotid artery pseudoa-neurysm in head and neck

目的分析头颈部假性颈动脉瘤的影像学表现,尤其是血管造影检查,以提高其诊断价值。方法回顾性分析32例头颈部假性颈动脉瘤的影像学及临床资料。结果影像学检查均能明确诊断,其中颈总动脉瘤2例,颈动脉分叉处瘤18例,颈内动脉瘤10例,颈外动脉瘤2例。影像学主要表现为所有瘤腔内造影剂滞留,瘤腔内形成涡流者18例,动脉瘤开口处"喷射征"14例,颈动脉分叉角度增大,颈内、外动脉移位者18例。结论影像学检查有利于头颈部假性颈动脉瘤的诊断和治疗方式的选择。

OBJECTIVE To make a further understanding of the imaging findings of the carotid artery pseudoaneurysm （CAPA） in head and neck and to explore the clinical value of imaging in diagnosis of it, especially the angiographic diagnosis. METHODS The clinical and imaging data of 36 patients with CAPA were analyzed retrospectively. The imaging appearances in all of the patients were observed by two experienced radiologists together and formed a consensus interpretation. RESULTS Imaging examination can establish definitive diagnosis in all cases. The parent arteries included the common carotid artery （2 case）, common carotid artery bifurcation （18 cases）, internal carotid artery （10 cases） and external carotid artery （2 cases）. The imaging features of the CAPA were： the contrast media retained in the aneuysm in all cases; the aneuysm lumen with turbulent flow in 18 cases; the jetting sign at the leak of the parent artery in 14 cases; increase of bifurcation angles of internal and external carotid arteries in 24 cases. CONCLUSION Imaging examination is the most valuable examination method in diagnosis of CAPA, and it can not only make definitive diagnosis, but also play an important role in selection of therapeutic planning.