颈部搏动性肿块的影像学诊断

目的探讨颈部搏动性肿块的影象学诊断价值，并着重分析其血管造影征象。材料与方法经病理和临床证实的颈部搏动性肿块患32例，其中颈动脉体瘤9例．动静脉瘘7例、颈动脉瘤5例．颈部假性动脉瘤3例．颈动脉迂曲症7例和巨大蔓状血管瘤1例。所有患均行选择性颈动脉造影，20例行血流超声检查．4例行CT检查、1例行MR检查、结果32例患中术前血管造影正确诊断31例，其中21例与病理结果相符，仅有1例假性动脉瘤误诊为真性动脉瘤；所有病变均显示其大小．起源和与周围大血管的关系。2例假性动脉瘤和5例颈动脉迂曲症彩超术前误诊为真性颈动脉瘤。结论选择性颈动脉造影足一种安全可靠的低创伤性影像学检查方法，结合其他影像学技术如彩超．CT、MR等口，准确做出定位和定性诊断。

Imaging diagnosis of cervical pulsatile masses

Objective To explore the value of imaging diagnosis for cervical pulsatile masses and to analyze emphatically their characteristics on angiographic images. Methods Thirty - two patients with surgically and clinically proven cervical pulsatile masses which included 9 carotid body tumors, 7 arteriovenous fistula, 5 carotid artery tumors. 3 cervical pseudoaneurysms, 7 carotid artery flexuous signs. and 1 macro angioma arteriale racemosum initially underwent selective carotid arteriography, in addition, 20 patients underwent bloodflow Doppler sonography, 4 patients underwent computed tomography (CT), and 1 patient underwent magnetic resonance (MR) examination. Results Among the 32 patients with cervical pulsatile masses, the previous angiography correctly diagnosed 31 patients (96.8% ) in whom the angiographic findings in 21 patients were corresponding to that of the postoperative pathology, while only 1 patient with pseudoaneurysm was misdiagnosed as true aneurysm. At the same time. all the lesions revealed the size. origin. and relation between them and their surrounding big blood vessels. On preoperative color Doppler sonography, 2 pseudoaneurysms and 5 carotid flexuous signs were misdiagnosed as true aneurysms. Conclusion selective carotid angiography is a safe, reliable, and less - traumatic diagnostic method, if this method combine with other imaging techniques such as color Doppler sonography, CT or MR and then it can accurately does out the correct topical and qualitative diagnosis for cervical pulsatile masses.