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目的 探讨无创性磁共振成像 (MRI)和磁共振血管造影 (MRA)对颈动脉间隙肿瘤的诊断价值 ,及其对术前制定手术方案的作用。方法 对临床可疑或确诊为颈动脉间隙肿瘤的 2 6例患者进行了术前颈部MRI和MRA检查 ,观察病变的形态、边界、内部信号 ,病变与颈动脉、分支动脉和颈内静脉的关系 ,以及颈总动脉分叉角度。结果 在 2 2例经手术或活检病理证实的患者中 ,颈动脉体瘤14例 (15个 ) ,颈动脉瘤 4例 ,神经鞘瘤 3例 ,转移性低分化鳞状细胞癌 1例。另有 4例经MRI和MRA检查及临床随访证实 ,3例为一侧较对侧明显增粗的颈总动脉 ,1例为迂曲走行的颈总动脉。MRI结合MRA检查对本组颈动脉体瘤和颈动脉瘤术前诊断均正确 ,并且MRI、MRA原始像及MRA三维重建像可提供准确的肿瘤与颈动脉及分支的关系。结论 无创性MRI和MRA检查对颈动脉间隙肿瘤 ,特别对颈动脉体瘤和颈动脉瘤的诊断优于其他检查方法 ,可以替代以往所必须进行的有创性颈动脉造影。
Objective To investigate the diagnostic value of noninvasive magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) for carotid artery interstitial tumors and its effect on preoperative surgical planning. Methods Preoperative neck MRI and MRA were performed on 26 patients with clinically suspected or confirmed carotid interstitial tumors. Morphology, border, internal signals, pathological changes and the relationship between carotid artery, branch artery and internal jugular vein were observed , And carotid bifurcation angle. Results Of the 22 patients who were confirmed by surgery or biopsy, there were 14 carotid body tumors (n = 15), 4 carotid aneurysms, 3 schwannoma, and 1 poorly differentiated squamous cell carcinoma. Another 4 cases were confirmed by MRI and MRA examination and clinical follow-up. Three cases were common carotid artery with obvious thickening on the one side and one common tortuous carotid artery. MRI combined with MRA examination of this group of carotid body tumor and carotid aneurysm are correct preoperative diagnosis, and MRA MRA original image and MRA three-dimensional reconstruction can provide accurate tumor and carotid artery and the relationship between the branches. Conclusion Noninvasive MRI and MRA are superior to other methods in the diagnosis of carotid interstitial tumors, especially carotid body tumors and carotid aneurysms. They can replace invasive carotid artery angiography which has been necessary in the past.