Jin Zhan-Qiang, He Wen, Wu Dong-Fang, Lin Mei-Ying, Jiang Hua-Tang
Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Ultrasound Med Biol. 2016 Sep;42(9):2106-13. doi: 10.1016/j.ultrasmedbio.2016.04.007. Epub 2016 Jun 15.
A carotid body tumor (CBT) is a rare, non-chromaffin paraganglioma, and its diagnosis mainly depends on imaging modalities. The aim of this study was to investigate the ability of color Doppler ultrasound (CDU) in the diagnosis and assessment of CBT based on computed tomography (CT). We retrospectively reviewed the CDU and CT features of 49 consecutive CBTs and 23 schwannomas from 67 patients and compared these findings with surgical resection specimens. The mean size of CBT lesions on ultrasound scans and CT angiography (CTA) was 3.24 cm ± 0.82 cm (range, 1.6-5.2 cm) and 3.84 cm ± 1.08 cm (range, 1.8-6.8 cm), respectively, which had statistically significant difference (t = 9.815, p = 0.000). The vascularity of CBT lesions was richer than that of schwannoma lesions (p < 0.05). Intra-lesional vascularities feeding CBT mostly arose from the external carotid artery and had spectrum characteristics including low velocity and resistance. Peak systolic velocity (PSV) and resistance index (RI) of the vasa vasorum were 39.8 cm/s ± 19.8 cm/s and 0.54 ± 0.06, respectively. There was the correlation between CTA and CDU in identifying Shamblin type I CBT lesions, while CTA technique was superior for CDU, identifying Shamblin type II and III CBT lesions. Accuracy, specificity and sensitivity of CDU in diagnosing CBTs were 87.5% (63 of 72), 82.6% (19 of 23) and 89.8% (44 of 49), respectively. Both accuracy and sensitivity of CTA in diagnosing CBTs were 100%. CDU can be useful for assessment of Shamblin's type and intra-lesional blood flow of CBTs before its metastases, while CT imaging can reveal the relationship between lesions and adjacent arteries, as well as the involvement of the skull base. CDU combined with CT imaging can be used as an optimal detection modality for the assessment and management of CBT.
颈动脉体瘤（CBT）是一种罕见的非嗜铬性副神经节瘤，其诊断主要依赖于影像学检查。本研究旨在探讨彩色多普勒超声（CDU）基于计算机断层扫描（CT）在CBT诊断及评估中的能力。我们回顾性分析了67例患者中连续49例CBT及23例神经鞘瘤的CDU和CT特征，并将这些结果与手术切除标本进行比较。超声扫描及CT血管造影（CTA）上CBT病变的平均大小分别为3.24 cm±0.82 cm（范围1.6 - 5.2 cm）和3.84 cm±1.08 cm（范围1.8 - 6.8 cm），差异具有统计学意义（t = 9.815，p = 0.000）。CBT病变的血管分布比神经鞘瘤病变更丰富（p < 0.05）。为CBT供血的瘤内血管大多起源于颈外动脉，具有低速和低阻力的频谱特征。穿通血管的收缩期峰值速度（PSV）和阻力指数（RI）分别为39.8 cm/s±19.8 cm/s和0.54±0.06。在识别Shamblin I型CBT病变方面，CTA与CDU存在相关性，而在识别Shamblin II型和III型CBT病变方面，CTA技术优于CDU。CDU诊断CBT的准确性、特异性和敏感性分别为87.5%（72例中的63例）、82.6%（23例中的19例）和89.8%（49例中的44例）。CTA诊断CBT的准确性和敏感性均为100%。CDU可用于在CBT转移前评估其Shamblin分型及瘤内血流情况，而CT成像可显示病变与相邻动脉的关系以及颅底受累情况。CDU联合CT成像可作为评估和处理CBT的最佳检测方式。
