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目的:探讨CT增强扫描与DSA(数字减影血管造影)诊断鼻咽纤维血管瘤的临床价值。方法:选择临床拟诊鼻咽纤维血管瘤25例,分别进行CT增强扫描与DSA检查,重点观察肿瘤大小、密度、侵犯范围、强化情况,以及骨质改变和血液供应等,再与手术或病理资料进行比对。结果:CT常规扫描结果均表现为鼻咽腔内软组织密度肿块,呈圆形或椭圆形,沿周围间隙蔓延的肿瘤呈类圆形、分叶状、哑铃状或多头状,平扫密度类似周围软组织,CT值平均为39Hu;增强扫描后肿块均有明显强化,CT值平均为98Hu。DSA检查可见肿瘤呈明显造影剂浓聚,显示肿瘤供血动脉来自颈外动脉分支的上颌动脉和咽升动脉15例,来自颈内动脉翼管动脉、圆孔动脉等岩段分支4例,来自眼动脉筛支6例。两项检查结果均与手术或病理资料相符。结论:CT增强扫描结合DSA检查,对鼻咽纤维血管瘤的术前评估、分期及放疗定位具有重要指导作用。
Objective: To investigate the clinical value of enhanced CT and digital subtraction angiography (DSA) in the diagnosis of nasopharyngeal hemangioma. Methods: Twenty-five patients with nasopharyngeal fibro-hemangioma were enrolled in this study. CT scan and DSA were performed respectively. The tumor size, density, extent of invasion, enhancement, bone turnover and blood supply were observed. Surgical or pathological Data comparison. Results: The results of routine CT scan showed the soft tissue mass in the nasopharynx, with a round or oval shape. The tumor spreading along the surrounding space was round, lobulated, dumbbell-shaped or long, The average CT value of soft tissue was 39 Hu. After the enhancement scanning, the mass of the tumor was significantly enhanced, with an average CT value of 98 Hu. DSA showed that the tumor showed obvious contrast agent accumulation, showing that the tumor feeding artery came from the external carotid branch of the maxillary artery and pharyngeal ascending artery in 15 cases, from the internal carotid artery vascularized artery and other branches of the petrous branch in 4 cases, from the eye Artery mesh in 6 cases. Both tests are consistent with the surgical or pathological data. Conclusion: CT enhanced scan combined with DSA has important guiding significance for the preoperative evaluation, staging and radiotherapy localization of nasopharyngeal fibroadenoma.