颈动脉体瘤与颈动脉三角区神经鞘瘤的鉴别诊断

目的：比较颈动脉体瘤与颈动脉三角区神经鞘瘤的数字减影血管造影（DSA）和多层螺旋CT（MSCT）增强扫描的影像学特征,为两者的鉴别诊断提供经验和教训。方法：回顾性分析颈动脉体瘤与颈动脉三角区神经鞘瘤各4例,总结各自的DSA、MSA、MSCT增强扫描影像学特征,分析误诊原因。结果：颈动脉体瘤区别于神经鞘瘤的DSA特征为：瘤体染色早,旦迅速浓染;增强MSCT特征为：瘤体迅速显著强化。神经鞘瘤区别于颈动脉体瘤的DSA特征为：瘤体染色晚,在静脉期,且染色淡,或几乎不染色;增强MSCT特征为：瘤体强化不明显,且呈“斑驳”样改变。本组1例来源于颈交感干的神经鞘瘤,术前DSA误诊为颈动脉体瘤,误诊的原因为：仅注意瘤体的部位、颈内、外动脉移位特征,而忽视了瘤体的血供、染色、强化等主要特征。结论：颈动脉体瘤与颈动脉三角区神经鞘瘤的DSA、MSCT增强扫描影像学特征明显不同,对两者的鉴别诊断具有重要的临床应用价值。

Differential diagnosis between carotid body tumor and neurilemmoma in carotid trigone

Objective：To compare the imaging features of DSA and MSCT between carotid body tumor and neurilemmoma in carotid trigone ,for the purpose to summarizhing the experiences of their differential diagnosis Methods：Retrospectively collected 8eases of carotid body tumor and neurilemmoma in carotid trigone,with each 4 cases. Their inaging features of DSA and contrast-enhanced MSCT were revieved and the misdiagnosis reasons were analyzed. Results ：The DSA features of carotid body tumor differentiates neurilemmoma in carotid were as follows ：relatively early dyed and quickly concentrated;while the features of contrast-enhanced MSCT were the tumor body was quickly significantly enhanced. The DSA features of neurilemmoma differentiates carotid body tumor were as follows ： relatively delayed light dyeing in venous period or almost no dyeing,while the features of contract-enhanced MSCT were relatively less enhanced but mottled changes. One neunilemmoma case originally from sympathetic nerve was misdiagnosed as carotid body tumor by DSA before surgery. The reasons of misdiagnosis were only pay attention to the location,the shift of internal and extemal carotid arteries ,while ignored the characteristics of blood supply,dyeing and enhancement of tumor body. Conclusion：The imaging features of DSA and MSCT between carotid body tumor and neurilemmoma in carotid trigone are markedly different. Pay attention to them are very important for the differential diagnosis in the clinical practice.