MRI在颈动脉体瘤术前评估中的价值

Value of MRI in preoperative evaluation of carotid body tumor

目的探讨MRI在颈动脉体瘤术前评估中的价值。方法回颐性分析2008年1月-2015年5月中国医学科学院肿瘤医院具有完整临床、影像及手术或病理资料的28例32侧颈动脉体瘤。分别从血管贴邻长度、显示无强化血管壁、血管推移、包绕角度及颈动脉狭窄方面分析肿瘤切除组、肿瘤剥离及动脉修复组、肿瘤及动脉切除组MRI图像，并与手术病理结果对照。结果肿瘤切除组、肿瘤剥离及动脉修复组、肿瘤及动脉切除组血管贴邻长度分别为（3．2±0．8）、（3．4±0．7）、（3．8±1．0）cm，各手术组间比较差异无统计学意义（P=0．577）。血管推移指标在各手术组间比较差异无统计学意义（P=0．859）。显示无强化血管壁、包绕角度及颈动脉狭窄指标在各手术组问比较差异均有统计学意义（均P〈0．01）。与手术病理结果对照，以显示无强化血管壁〈2／3周、包绕角度〉1／3周和颈动脉狭窄为指标，判断颈动脉修复或切除，其敏感度、特异度、准确度分别为86．4％、90％、87．5％；86．4％、90％、87．5％；80％、100％、93．7％。结论显示无强化血管壁、包绕角度及血管狭窄与颈动脉手术干预具有相关性。以显示无强化血管壁〈2／3周、包绕角度〉1／3周及颈动脉狭窄作为指标，对颈动脉体瘤术前评估有一定价值，颈动脉推移、血管贴邻长度在术前评估中价值有限。

Objective To evaluate the value of MRI in preoperative evaluation of carotid body tumor. Methods A retrospective study was including 32 CBT of 28 patients of carotid body tumor with complete clinical,imaging and pathological data in our hospital. The MRI images of vascular adjacent length, no enhancement vascular wall, carotid displacement, wrapping angle and carotid stenosis were analyzed respectively in tumor resection group, tumor dissection and artery repair group, and tumor and artery resection group. The results were compared with surgery. Results The indexes of vascular adjacent average length were （ 3.2 ± 0. 8）, （3.4 ± 0. 7 ） and （ 3.8 ± 1.0） cm, respectively. The indexes of vascular adjacent average length and vascular displacement, which all showed no significant difference between each operation group（P = 0. 577, 0. 859）. The indexes of no enhancement vascular wall, wrapping angle and carotid stenosis, which all showed significant difference between each operation group （ all P 〈 0. 01 ）. Compared with the surgical and pathological findings, with no enhancement vascular wall 〈 2/3 circumference as the index of carotid artery repair or resection, the sensitivity, specificity and accuracy were 86. 4% , 90% , 87.5% respectively. With wrapping angle 〉 1/3 circumference as the index of carotid artery repair or resection,the sensitivity, specificity and accuracy were 86.4%, 90%, 87.5% respectively. With carotid stenosis as the index of carotid artery resection,the sensitivity, specificity and accuracy were 80% , 100% , 93.7% respectively. Conclusion The no enhancement vascular wall, wrapping angle and carotid stenosis have a correlation with carotid artery intervention. The no enhancement vascular wall 〈 2/3 circumference, wrapping angle 〉 1/3 circumference and carotid stenosis have a certain value in preoperative evaluation of carotid body tumor, although vascular adjacent average length and vascular displacement have limited value.