Phelps P D, Cheesman A D
Department of Radiology, Royal National Throat, Nose and Ear Hospital, London, England.
Arch Otolaryngol Head Neck Surg. 1990 Aug;116(8):940-5. doi: 10.1001/archotol.1990.01870080062017.
Traditionally, jugulotympanic tumors, also called chemodectomas or paragangliomas, have been evaluated by conventional imaging to show bone erosion and angiography for the definitive diagnosis, location, and extent. More recently, computed tomography has been used to show these features as well as the intracranial extension. Magnetic resonance imaging has added a new dimension, particularly for assessment of intracranial spread and growth downward into the neck. We examined 20 jugulotympanic glomus tumors by computed tomography and magnetic resonance imaging with gadolinium enhancement and believe that these two imaging modalities, combined with clinical assessment, can provide all the necessary information regarding diagnosis, situation, and extent in the majority of jugulotympanic glomus tumors. Gadolinium-enhanced magnetic resonance imaging was particularly effective for the detection of small tumors confined to the middle ear and for confirmation that the jugular bulb was not involved. Consequently, angiography is no longer a first-line imaging investigation but rather a preoperative evaluation only in those tumors in which preoperative embolization is required or occasionally when the extent of the tumor, especially in the jugular bulb, cannot be confidently predicted by noninvasive imaging.
传统上，颈鼓室肿瘤，也称为化学感受器瘤或副神经节瘤，一直通过传统影像学检查来显示骨质侵蚀，并通过血管造影进行明确诊断、定位和评估范围。最近，计算机断层扫描也用于显示这些特征以及颅内扩展情况。磁共振成像增加了一个新的维度，特别是对于评估颅内扩散和向下延伸至颈部的生长情况。我们通过计算机断层扫描和钆增强磁共振成像检查了20例颈鼓室球瘤，并且认为这两种成像方式，结合临床评估，能够为大多数颈鼓室球瘤提供有关诊断、情况和范围的所有必要信息。钆增强磁共振成像对于检测局限于中耳的小肿瘤以及确认颈静脉球未受累特别有效。因此，血管造影不再是一线成像检查，而仅在那些需要术前栓塞的肿瘤或偶尔在非侵入性成像无法可靠预测肿瘤范围（特别是在颈静脉球）的情况下进行术前评估。
