颈部副神经节瘤的MR诊断

MR diagnosis of cervical paragangliomas

目的:探讨颈部副神经节瘤的MR诊断价值.方法:回顾性分析34个肿块(32例患者)的部位、MR信号和邻近大血管移位等情况.结果:病变分别位于颈动脉体(27个,2例为双侧性)、迷走神经体(6个,上颈部4个,中、下颈部各1个)及左侧后颈部(1个).右侧颈部15个,左侧19个.肿瘤形态为不规则形、纺锤形或类圆形;信号欠均匀,MR平扫(22/34)及增强后(18/29)可见"盐和胡椒征".22个肿块行MRA检查,表现为颈总动脉分叉扩大(18个颈动脉体瘤)和颈动脉向前移位(4个迷走神经体瘤).2例恶性迷走神经体瘤颈部淋巴结转移,其中1例双肺转移.结论:根据肿瘤的部位、信号等MR表现,多数颈部副神经节瘤可在手术前正确诊断.

AIM： To evaluate the value of MR in the diagnosis of cervical paragangliomas. METHODS ： Thirty-four masses （32 cases） of the cervical paragangliomas were retrospectively analysed, with the emphasis on the locations, MR signal intensities and dislocation of the carotid vessels. RESULTS： The tumors were located in the carotid bodies （27 masses, bilaterally in 2 cases） ,vagus nerve bodies（6 masses, 4 in the superior neck, and 1 in the middle and inferior neck, respectively） and left posterior neck （ 1 mass）, respectively. The tumors were demonstrated as round, oval or irregular shapes, with right-sided in 15 masses and left-sided in 19 masses. The signal intensities of the tumors were heterogeneous, combined with ＂salt and pepper＂ appearance in 22 masses（22/34） on plain MR imaging and 18 masses（18/29） on enhanced MR imaging. On MR angiography performed in 21 eases （22 masses）, the bifurcations of the common carotid arteries were enlarged in 18 carotid body tumors, and the carotid arteries were displaced in 4 vagal paragangliomas. The metastasis of the cervical lymph nodes were found in 2 vagal paragangliomas with one of them transfering to the bilateral lungs. CONCLUSION： Most cervical paragangliomas could be correctly diagnosed before surgery according to their MR presentations.