数字减影血管造影在颈静脉球瘤诊治中的应用

Digital subtraction angiography on giomus jugulares tumors

目的探讨数字减影血管造影（digital subtraction angiography，DSA）、球囊阻断试验及供血动脉栓塞在颈静脉球瘤诊治中的应用价值。方法14例颈静脉球瘤术前接受了DSA检查，其中10例DSA术中行球囊阻断试验及选择性供血动脉栓塞。结果所有14例患者DSA检查均发现肿瘤富含血管，5例显示颈内动脉受压变细。术中发现咽升动脉为主要供血动脉。14例患者中10例接受了球囊阻断试验，8例能耐受，2例不能耐受；并行肿瘤供血动脉栓塞术，肿瘤血供明显减少。DSA术及球囊阻断试验、供血动脉栓塞术后无1例出现脑血管意外并发症。10例患者颈静脉球瘤切除术中结扎切除了患侧颈内动脉，术后有2例出现心脑血管并发症。接受术前供血动脉栓塞的患者术中出血明显少于未行血管栓塞术者。结论DSA、球囊阻断试验及供血动脉栓塞术可提高颈静脉球瘤的手术安全性。

Objective To analysis the effectiveness of preoperative digital subtraction angiography （DSA） on glomus jugulares tumors. Methods A retrospective study of 14 cases of glomus jugulares tumors which received preoperative DSA was carried out. Among them, 10 cases were accepted balloon occlusion test and selective embolization of supplied vessels. Results Hypervascular changes was found in all 14 cases and compression of internal carotid artery was found in 5 cases. Ascending pharyngeal artery was the main supplied vessel. Balloon occlusion test was applied in 10 cases, 2 were intolerable and 8 were passed occlusion test. Ten cases were accepted embolizations and tumor blood supply was conspicuous decreased. Neurovascular complications did not occurred after DSA but pospostoperatively in 2 cases. Intraoperative bleeding was less in embolization patients than that of without embolization. Conclusions Preoperative DSA association with balloon occlusion test and embolizations might be a safe option on surgery of glomus jugulares tumors.