颈内动脉颈段走行异常的影像解剖研究

Anatomy of the aberrant cervical internal carotid artery under CT angiography and MRI

目的探讨颈内动脉颈段走形异常的CTA、MRI表现。方法回顾性分析2012年1月-2016年12月在我院对临床怀疑脑血管病或体检行头部及头颈部CTA检查的389例患者的影像资料,发现15例异常患者,还有1例行MRI平扫检查确定,观察颈内动脉颈段走形位置异常的部位及走行线路异常的形态。结果颈内动脉颈段走形位置异常在CTA、MRI上表现为三种形式（1）鼻咽部粘膜下（2）口咽部粘膜下（3）横跨咽旁间隙并远离口鼻咽腔;走形路线异常形态有＂〉或〈＂状、＂C＂状、＂横U＂状、＂S＂状、＂Z或N＂状、圈状及＂3＂字状。结论颈内动脉颈段走形位置和走形线路异常,是同一事物的两个表现形式,CTA检查不仅能从横断位局部观察走形位置异常,而且通过VR后处理技术整体上显示走形线路异常,可为临床咽部手术及脑血管疾病诊断提供可靠的影像解剖学依据。

Objective To describe imaging anatomy features of the aberrant cervical segment of internal carotid artery through CTA and MRI skill. Methods The radiological data of 389 cases between Jan. 2012 to Dec. 2016 were collected and analyzed, who underwent head or head-neck CTA due to cerebrovascular disease or health examination. 15 cases were recognized with the aberrant cervical segment of internal carotid artery, 1 case of aberrant internal carotid artery was identified under 1.5 T MRI. Abnormal location and the line exception form of cervical segment of internal carotid artery were observed and described. Results Three forms of abnormal location of cervical segment of internal carotid artery coulb be find under CTA and MRI： 1. submucosal position at the oropharynx; 2. submucosal position at the nasopharynx; 3. pass through the paprapharynx spcae and far away from the oropharynx or nasopharynx cavity. The line exception form included or-shaped, C-shaped, cross-U-shaped, S-shaped, Z-or N-shaped,coiling-shaped, or 3-shaped. Conclusions CTA examination can be used to observe the local axial abnormal contorts of the artery, moreover, by VR post-processing technology, the overall artery contorts can be demonstrated, which is a reliable clue for clinical pharyngeal surgery and cerebrovascular disease diagnosis.