术前双源 CT 引导在颈动脉体瘤中的意义。

Significance of the preoperative guidance of dual-source CT in carotid body tumor.

机构信息

Shandong University, Shandong Medical Imaging Research Institute, Jinan, Shandong, China.

出版信息

Chin Med J (Engl). 2010 Oct;123(20):2816-9.

Abstract

BACKGROUND

Accurate views of the head and neck vessels, tumor angiogenesis and the relationship of tumor and the surrounding blood vessels are especially crucial to carotid body tumor (CBT) patients. The aim of this study was to explore the value of dual-source CT (DSCT) cerebral and carotid angiography in CBT diagnosis.

METHODS

DSCT cerebral and carotid angiography was performed on nine patients with CBT. Two-dimensional and three-dimensional reconstruction images were obtained by means of multiple planar reconstructions (MPR), maximum intensity projection (MIP) and volume rendering (VR). All patients were subjected to color Doppler flow imaging (CDFI) examination. Two kinds of examinations were performed in 3 days, and all patients were confirmed by surgery.

RESULTS

DSCT angiography was successful in all patients. CBTs were diagnosed in 9 patients with 10 lesions (1 case had multiple bilateral CBTs). The largest lesion was 12 cm in diameter, and the smallest one was 1.6 cm in diameter. All patients had clearly demonstrated head and neck vessels, tumor angiogenesis, and tumor relationship with the surrounding blood vessels. The internal and external carotid artery (ICA, ECA) were involved in 2 cases. There were 7 cases with basilar artery ring integrity, and 1 case had the posterior communicating artery absent; 1 case had middle cerebral artery stenosis; 4 cases (4 tumors) showed arterial phase homogeneous enhancement; 5 cases (6 tumors) had obvious heterogeneous enhancement where irregular low-density necrosis could be seen in the tumors. CDFI could demonstrate the nearby blood vessels and tumor structure, instead of tumor angiogenesis. However, DSCT can display both the tumor and the peripheral vascular tumor angiogenesis consistent with surgical findings.

CONCLUSIONS

DSCT cerebral and carotid angiography can provide reliable information for the operation. It might be a valuable CBT diagnostic method by showing accurate views of the CBT along with the bilateral neck and brain blood vessels.

摘要

背景

准确观察头颈部血管、肿瘤血管生成以及肿瘤与周围血管的关系，对颈动脉体瘤（CBT）患者尤为重要。本研究旨在探讨双源 CT（DSCT）脑及颈动脉血管造影在 CBT 诊断中的价值。

方法

对 9 例 CBT 患者进行 DSCT 脑及颈动脉血管造影。通过多平面重建（MPR）、最大密度投影（MIP）和容积再现（VR）获得二维和三维重建图像。所有患者均行彩色多普勒血流成像（CDFI）检查。两种检查在 3 天内完成，所有患者均经手术证实。

结果

DSCT 血管造影均成功。9 例患者共 10 个病灶诊断为 CBT（1 例为双侧多发 CBT）。最大病灶直径为 12cm，最小病灶直径为 1.6cm。所有患者均清晰显示头颈部血管、肿瘤血管生成及肿瘤与周围血管的关系。2 例累及颈内动脉（ICA、ECA），7 例基底动脉环完整，1 例后交通动脉缺如，1 例大脑中动脉狭窄，4 例（4 个肿瘤）呈动脉期均匀强化，5 例（6 个肿瘤）呈明显不均匀强化，肿瘤内可见不规则低密度坏死。CDFI 可显示邻近血管和肿瘤结构，但不能显示肿瘤血管生成。然而，DSCT 可显示肿瘤及其周围血管肿瘤血管生成，与手术结果一致。