论文部分内容阅读
目的探讨颈部舌骨上咽旁间隙的神经鞘瘤和颈动脉体瘤的特征性影像学表现,旨在提高对该病变的术前诊断准确率。方法回顾性分析2014年7月至2016年11月经手术病理证实的8例咽旁间隙神经鞘瘤和4例颈动脉体瘤患者的临床影像学资料,分析两者的影像学特点,为临床鉴别诊断提供参考。结果 (1)神经鞘瘤8例,CT示病灶均境界清晰、光整;其中4例瘤体使颈内、外动脉分离,4例使颈内动脉与颈内静脉分离,3例颈内外动脉向外移位;神经鞘瘤位置多变。3例CT平扫信号呈均匀稍低密度影,6例CT增强呈轻-中度渐进性强化。3例MRI显示,T1WI呈稍低信号,T2WI呈混杂稍高-高信号,其中2例增强扫描表现为明显强化,病灶内未见流空血管信号,周围未见明显增粗供血血管。(2)颈动脉体瘤4例,均有浅分叶征存在;瘤体均骑跨于颈动脉分叉处,颈内、外动脉分离移位明显,呈“抱球征”或“高脚杯征”。平扫CT呈均匀软组织密度影;3例CT增强明显均匀强化,1例不均匀显著强化。结论根据咽旁间隙神经鞘瘤和颈动脉体瘤的病变位置、形态、强化方式及与邻近血管的关系,CT和MRI检查可以做出准确鉴别。
Objective To investigate the characteristic imaging findings of schwannomas and carotid body tumors in the parapharyngeal space of the hyoid bone in order to improve the accuracy of preoperative diagnosis of this lesion. Methods The clinical imaging data of 8 patients with parapharyngeal schwannoma and 4 patients with carotid body tumor confirmed by surgery and pathology from July 2014 to November 2016 were retrospectively analyzed. The imaging features of both were analyzed. Diagnosis for reference. Results (1) Schwannoma in 8 cases, CT showed lesions were clear, smooth; 4 cases of the tumor to the internal and external carotid separation, 4 cases of internal carotid artery and internal jugular vein separation, 3 cases of internal and external carotid artery Outward shift; Schwannoma changeable position. Three cases of CT scan showed a uniform low density, 6 cases of CT enhancement was mild to moderate progressive enhancement. Three cases of MRI showed that T1WI was slightly lower signal, T2WI was mixed slightly higher - high signal, 2 cases of enhanced scan showed significantly enhanced, no flow within the lesion vascular signals, no significant thickening of the surrounding blood vessels. (2) There were 4 cases of carotid body tumor, all of them had superficial lobes sign. The tumors all straddled the bifurcation of the carotid artery, the internal carotid artery and external artery were separated and shifted obviously, “Goblet sign ”. Plain CT showed uniform soft tissue density; 3 cases of CT enhancement was significantly enhanced, 1 case of uneven significantly enhanced. Conclusion According to the lesion location, shape and enhancement of schwannoma and carotid body tumor in the parapharyngeal space, the relationship between adjacent schwann vessels and the adjacent vessels can be accurately identified by CT and MRI.