颈静脉球瘤的CT及MRI表现

CT and MRI Diagnosis of Glomus Jugulare Tumors

目的探讨颈静脉球瘤的CT和MRI表现,提高诊断准确性。方法对11例经手术和组织学证实的颈静脉球瘤的CT和MRI资料进行回顾性分析。结果11例颈静脉球瘤,左侧7例,右侧4例;病变以颈静脉孔为中心生长并向周围结构不同程度蔓延。病变边界均清楚,呈卵圆形2例,哑铃形1例,不规则形8例。颞骨高分辨CT(HRCT)表现:与脑组织比较,颈静脉孔区软组织肿块呈等密度,周围的骨质呈虫蚀样或不规则破坏,其中7例鼓室下壁骨质破坏,肿块进入下鼓室并有2例听小骨破坏,2例侵犯内耳道和外耳道,4例颈动脉管骨质破坏,5例岩尖骨质破坏,6例斜坡骨质破坏。MRI表现:颈静脉孔区软组织肿块,边缘清楚。全部11例中,与脑灰质比较,MRT1WI呈低信号3例,等信号8例,T2WI均为高信号,增强T1WI呈明显不均匀强化,9例(82%)在T2WI和增强T1WI上可显示"盐和胡椒"征。6例小脑受压,3例延髓、小脑同时受压。MRA表现:未见明显异常改变。MRV表现:2例乙状窦及颈内静脉受压。结论联合使用CT和MRI两种检查方法能够为颈静脉球瘤的诊断和治疗提供更多信息。

Objective To investigate the CT and MR imaging findings of Glomus Jugulare tumors to increase the recognization for it. Methods All 11 Glomus Jugulare tumors were verified by operation and pathology. The CT and MR imaging data of 11 Glomus Jugulare tumors were analyzed retrospectively. Results Of the 11 cases, 7 were located in the left neck and 4 in the right neck. The lesions were arised from jugular foramen and extended into the adjacent structures. The lesions showed a well-defined margin with oval shape in 2 cases, dumbbell shape in 1 case, and irregular shape in 8 cases. On high-resolution computed tomography （HRCT） of the temporal bone, the lesions appeared as a isodensity mass compared with brain tissue, and caused the enlargement of the foramen jugulare with adjacent month-eaten or irregular bony destruction. Tumors eroded into the floor of the hypotympanum in 7 cases with ossicles destruction in 2 cases, and into the internal and external auditory meatus in 2 cases. Bone destruction occurred in the horizontal segment of the carotid canal in 4 cases, and in the petrous apex in 5 cases, and in the clivus in 6 cases. On MRI, a well-defined soft tissue was seen in the foramen jugulare. Of the 11 cases, on MR T1WI, tumor appeared hypointense signal compare with gray matter in 3cases and isointense signal in 8cases. On MR T2WI, tumors revealed hyperintense signal in all cases. On MR contrast-enhanced T1WI, tumors appeared marked enhancement. T2WI and postcontrast T1WI demonstrated ＇salt-and-pep- per＇ appearance in 9cases （82%）.Cerebellum was compressed in 6cases, and both cerebellum and medulla oblongata were compressed in 3cases.On Magnetic resonance angiography （MRA）, no abnormality was found. On Magnetic resonance venography （MRV）, the sigmold sinus and the internal carotid vein were pressed in 2 cases. Conclusion Combined both CT and MRI can provide more information for the diagnosis and treatment of glomus jugular tumor.