彩色多普勒超声在颈动脉体瘤和颈部神经鞘瘤诊断与鉴别诊断中的应用价值分析

目的探讨彩色多普勒超声检查方法对颈动脉体瘤与颈部神经鞘瘤临床诊断的作用,以及在鉴别诊断中的价值。方法采用回顾性研究方法,选取2012年3月至2019年4月抚顺市中医院收治的36例颈动脉体瘤以及24例颈部神经鞘瘤患者,均通过手术病理诊断确诊,对两组患者的彩色多普勒超声以及二维声像图检查结果进行分析。结果36例颈动脉体瘤患者的肿瘤中,图像中未见明显的包膜,肿瘤边界较为清晰,形状相对规则,呈低回声,内部回声不均匀,肿瘤位置均在颈总动脉分叉位置的平面,包围颈内动脉以及颈外动脉的起始位置,颈总动脉分叉角度较大,颈内动脉以及颈外动脉的起始位置距离加大。29例颈动脉体瘤的肿块图像内部可见明显的血流信号,表现为低阻动脉频谱;6例肿瘤的肿块图像内部可见较少的点、线状的血流信号;1例肿瘤的肿块图像没有明显的血流信号。24例颈部神经鞘瘤中,图像中可见明确的包膜,肿瘤边界清晰,形状较为规则,呈低回声或囊实混合回声。3例肿瘤位置为颈动脉分叉位置的平面,包围颈总动脉分叉的平面,颈总动脉分叉角度较大;4例肿瘤的位置为锁骨上窝;17例肿瘤的位置在颈总动脉的附近,没有包围颈总动脉。15例肿瘤的肿块图像内部可见部分点、线状的血流信号;9例肿瘤的肿块图像内部未见明显的血流信号。结论颈动脉体瘤与颈部神经鞘瘤的超声影像学图像都存在一定的特征,在没有典型的临床特征情况下,以声像图特征进行参考诊断,能够较为准确地进行诊断,在颈动脉体瘤与颈部神经鞘瘤诊断以及鉴别诊断中有着较为重要的作用。

Application value of color doppler ultrasound in diagnosis and differential diagnosis of carotid body tumor and cervical schwannoma

Objective To explore the role of color doppler ultrasonography in the diagnosis and differential diagnosis of carotid body tumor and cervical schwannoma.Methods 36 cases of carotid body tumors and 24 cases of cervical schwannomas admitted to Fushun City Hospital of Traditional Chinese Medicine from March 2012 to April 2019 were selected in this retrospective study.All patients were diagnosed by surgical pathology.The results of color Doppler ultrasound and two-dimensional sonogram were analyzed.Results In the 36 cases of carotid body tumor patients,the tumors were relatively well-circumscribed without capsule,regular-shaped and hypoechoic with heterogenic texture.The tumors were all located at the carotid artery bifurcation,surrounding the initial site of internal carotid artery and external carotid artery.The angles of the carotid artery bifurcation were enlarged and the distances between the initial site of internal carotid artery and external carotid artery were increased.29 cases of carotid body tumor showed abundant vascular supply manifested as low-resistance arterial spectrum,6 cases showed internal point or linear blood flow signal,and 1 cases showed no internal blood flow signal.In 24 cases of cervical schwannoma patients,the tumors were well-circumscribed with obvious capsule,regular-shaped and hypoechoic or mixed echoic.3 cases were located at the carotid artery bifurcation,surrounding the initial site of internal carotid artery and external carotid artery.The angles of the carotid artery bifurcation were enlarged.4 cases were located in the supraclavicular fossa;17 cases were located near the common carotid artery but did not surround the common carotid artery.15 cases showed internal point or linear blood flow signal,and 9 cases showed no internal blood flow signal.Conclusion Sonography imaging has certain characteristics on carotid body tumor and cervical schwannoma.In the absence of typical clinical features,sonographic features can make reference for diagnosis,and plays an important role in diagnosis and differential diagnosis of the carotid body tumor and cervical schwannoma.