颈段颈内动脉走行变异的CT表现及临床意义

The clinical and computer tomography features of the aberrant internal carotid artery(ICA) in the cervical segment

目的探讨颈段颈内动脉走行变异的CT表现及临床意义。方法回顾性分析2012年9月~2012年12月因脑血管病或体检而行头颈部CTA检查的1812例临床及影像资料,评价所有患者的颈段颈内动脉的走行有无变异并进行测量。结果 1）检出颈段颈内动脉走行变异17例,发生率为0.938%（17/1812）。其中颈内动脉迂曲走行至口咽粘膜下4例（右侧1例,左侧1例,两侧2例）,变异段平均长度（10±1.22）mm;颈内动脉迂曲走行至鼻咽粘膜下10例（右侧5例,左侧4例,两侧1例）,变异段平均长度（5.36±2.69）mm;颈内动脉在口咽水平单纯迂曲（远离口鼻咽腔）3例,变异段平均长度12mm;2）17例颈内动脉走行变异者1例（1/17）有咽部异物感（口咽段变异者）,其余无明显临床症状。结论CTA可准确显示并评价颈段颈内动脉走行变异,提高其检出率,避免误诊。

Objective To describe the clinical and radiological features of the aberrant internal carotid artery（ ICA） in the cervical segment. Methods The clinical and radiological data were collectioned in 1812 cases between Sep 2012 and Dec 2012,who underwent the head and neck CTA due to cerebrovascular disease or health examination. All of the CTA were made with Aquilion one 320-row-640-slice MDCT. The results were analyzed and measured by professional radiology physicians. Results 1）of 1812 cases,17 were recognized with the aberrant internal carotid artery（ ICA）,the incidence was 0. 938%（ 17 /1812）; 2） 4cases were recognized with the aberrant in the oropharynx segment,the CTA showed that the internal carotid artery（ ICA） run adjacent to the central axis in the oropharynx level,in a posterior position of the oropharynx mucous membrane; 10 cases were recognized with the aberrant in the nasopharynx segment,in which the internal carotid artery（ ICA） run in a posterior position of the nasopharynx mucous membrane; 3 cases presented with a purely circuity of the internal carotid artery（ away from the oropharynx cavity）; All of the aberrant internal carotid arteries were circuitous,4 cases with mild stenosis; The mean length of the abnormal oropharynx segment was（ 10 ± 1. 22） mm; The mean length of the abnormal nasopharynx segment was（ 5. 36 ± 2. 69） mm; 3） 1case（ 1 /17） with the aberrant in the oropharynx segment had local symptom（ foreign bodies sensation in the pharyngeal portion）;There was not enough evidence showed that the 10 cases（ 10 /17） with anterior circulation ischemia was associated with the aberrant internal carotid artery in the cervical segment. Conclusion The variation of the aberrant internal carotid artery in the cervical segment was higher in Chinese. The position of the internal carotid artery should be confirmed before the oropharynx and nasopharynx in order to avoid serious complications. As a noninvasive examination technology,CTA can comprehend the Courser and aberrant of the internal carotid artery accurately,and finally provide reliable anatomical basis to the surgery.