Yılmazer Zorlu Sezer Nil, Uzun Çağlar, Düşünceli Atman Ebru, Ergüden Ruhi Erdem, Elhan Atilla Halil
Department of Radiology, Ankara Mamak State Hospital, Ankara 06270, Turkey.
Department of Radiology, Ankara University Faculty of Medicine, Ankara 06230, Turkey.
Br J Radiol. 2025 Aug 1;98(1172):1264-1271. doi: 10.1093/bjr/tqaf096.
Sympathetic nervous system hyperactivation in chronic conditions, such as hypertension and metabolic syndrome, can lead to carotid body (CB) hyperplasia, potentially mimicking small carotid body tumours (CBTs) in radiological evaluations. This study aimed to investigate CT angiography (CTA) findings to differentiate CBTs from non-neoplastic CBs.
Patients were categorized into CBT and non-neoplastic CB groups. Demographics (smoking status, hypertension, diabetes mellitus), shape, dimensions, volume, and density (including standard deviations) were assessed. Density ratios were calculated using CB/CBT and ipsilateral common carotid artery density. Diagnostic performance was evaluated via ROC analysis, and logistic regression identified factors associated with increased CBT risk.
Significant differences between the CB and CBT groups were found in gender, smoking status, and shape (P < .01), while age, location, hypertension, and diabetes mellitus showed no association (P > .05). The CBT group had significantly higher density, standard deviation, and density ratios (P < .001). Multivariate analysis, adjusted for age, gender, and smoking, showed that saddle shape, standard deviation ≥21.5, and density ratio ≥0.5603 predicted CBT diagnosis with 92.6% sensitivity and 99.3% specificity.
Saddle shape, along with increased density and standard deviation values, emerges as findings suggestive of a CBT diagnosis. The proposed imaging features may improve differentiation of small CBTs from non-neoplastic CBs, particularly in cases with enlarged CBs lacking typical tumour features.
Specific CTA findings, including saddle shape, increased density, and standard deviation, can effectively differentiate small CBTs from non-neoplastic CBs, offering a novel approach to improving radiological diagnostics in cases with CB hyperplasia.
在高血压和代谢综合征等慢性疾病中，交感神经系统的过度激活可导致颈动脉体（CB）增生，在影像学评估中可能会被误诊为小的颈动脉体瘤（CBT）。本研究旨在探讨CT血管造影（CTA）表现，以区分CBT与非肿瘤性CB。
将患者分为CBT组和非肿瘤性CB组。评估人口统计学特征（吸烟状况、高血压、糖尿病）、形状、尺寸、体积和密度（包括标准差）。计算CB/CBT密度比和同侧颈总动脉密度。通过ROC分析评估诊断性能，并采用逻辑回归确定与CBT风险增加相关的因素。
CB组和CBT组在性别、吸烟状况和形状方面存在显著差异（P < 0.01），而年龄、位置、高血压和糖尿病无相关性（P > 0.05）。CBT组的密度、标准差和密度比显著更高（P < 0.001）。在对年龄、性别和吸烟进行校正的多变量分析中，鞍形、标准差≥21.5和密度比≥0.5603预测CBT诊断的敏感性为92.6%，特异性为99.3%。
鞍形以及密度和标准差增加是提示CBT诊断的表现。所提出的影像学特征可能有助于提高小CBT与非肿瘤性CB的鉴别诊断，特别是在CB增大但缺乏典型肿瘤特征的病例中。
特定的CTA表现，包括鞍形、密度增加和标准差增加，可有效区分小CBT与非肿瘤性CB，为改善CB增生病例的放射学诊断提供了一种新方法。
