Weber A L, McKenna M J
Department of Radiology, Harvard Medical School, Boston, Massachusetts.
Neuroimaging Clin N Am. 1994 Aug;4(3):579-98.
The jugular foramen varies considerably in size and shape, along with the jugular vein. The foramen is traversed by several vessels and nerves. CT, in various section planes, demonstrates the bone anatomy optimally, whereas MR (including MR angiography) reveals the vascular and soft tissue structures to best advantage. A diverse group of vascular anomalies originate in the foramen and adjacent carotid canal that must be differentiated from tumors. The most common tumor within the jugular foramen is the hypervascular glomus jugulare tumor followed by neurogenic tumors, predominantly the schwannoma. Less common lesions comprise meningioma, hemangiopericytoma, chondrosarcoma, and plasmacytoma. Metastases and malignant tumors arising in adjacent anatomic structures (nasopharynx, parotid, and temporal bone), in advanced stages, may spread to the jugular foramen. Endolymphatic sac tumors arise at the posterior medial aspect of the petrous bone and frequently extend to the jugular foramen. Irregular lytic bone destruction, with enlargement and hypervascularity, demonstrated by CT and MR imaging, are characteristic for glomus jugulare tumors. Benign tumors, most commonly the jugular foramen schwannoma, display an enlarged jugular foramen with well-defined bone margins.
颈静脉孔的大小和形状与颈静脉一样变化很大。该孔有几条血管和神经穿过。CT在不同的断面平面上能最佳地显示骨质结构，而磁共振成像（包括磁共振血管造影）则能最清楚地显示血管和软组织结构。起源于该孔及相邻颈动脉管的多种血管异常必须与肿瘤相鉴别。颈静脉孔内最常见的肿瘤是富含血管的颈静脉球瘤，其次是神经源性肿瘤，主要是神经鞘瘤。较少见的病变包括脑膜瘤、血管外皮细胞瘤、软骨肉瘤和浆细胞瘤。晚期时，起源于相邻解剖结构（鼻咽、腮腺和颞骨）的转移瘤和恶性肿瘤可能扩散至颈静脉孔。内淋巴囊肿瘤起源于岩骨后内侧，常延伸至颈静脉孔。CT和磁共振成像显示的不规则溶骨性骨质破坏、扩大及血管增多是颈静脉球瘤的特征。良性肿瘤，最常见的是颈静脉孔神经鞘瘤，表现为颈静脉孔扩大，骨质边缘清晰。
