青少年鼻咽部纤维血管瘤的影像诊断及介入治疗

Imaging diagnosis and interventional therapy of juvenile nasopharyngeal angiofibroma

目的探讨青少年鼻咽部纤维血管瘤的影像学表现及介入治疗的价值。方法对15例青少年鼻咽部纤维血管瘤患者的影像学表现进行分析,并对肿瘤的供血动脉进行栓塞。结果 CT、MRI表现为鼻咽部的软组织肿块影,大部分边界清楚,密度或信号均匀,显著强化。部分可发现异常供血动脉;血管造影表现为鼻咽部的异常血管团,经异常供血动脉采用明胶海绵栓塞后止血效果肯定,术后血管瘤体积明显缩小,术中出血少。结论 CT、MRI有助于肿瘤诊断及定位;术前栓塞有助于减少术中出血,提高手术的全切率和安全性,是一种安全有效的方法。

Objective To discuss imaging manifestations of juvenile nasopharyngeal angiofibroma（JNA） and its interventional management.Methods Imaging finding,including CT and MRI,in 15 patients with JNA were analyzed.Interventional embolization of the feeding artery of JNA as the treatment was carried out.Results The CT and MRI showed a nasopharyngeal mass with well-defind margin,uniform density or signal and remarkably enhanced.It also could reveal the abnormal feeding arteries in some cases.JNA were demonstrated abnormal vessel blush in the carotid angiography,The feeding artery of JNA were embolized with gelatin sponge.Nose bleeding was controlled immediately.Volume of JNA was significantly shrink and blood loss in operation decreased.Conclusion CT and MRI can be contributed to the diagnosis and location of JNA.Preoperative embolotherapy for JNA can reduce the bleeding in the operation and increase the therapeutic effect of exairesis.It can be convinced that the preoperative embolotherapy is safe and effective.