颈静脉孔区肿瘤的CT和MRI诊断

目的：探讨CT和MRI对颈静脉孔区肿瘤的诊断及鉴别诊断。方法：回顾性分析了经手术病理证实的34例颈静脉孔区肿瘤的CT和MR影像资料,其中包括颈静脉球瘤12例,神经鞘瘤10例,转移瘤3例,脑膜瘤2例,神经纤维瘤、脊索瘤、软骨瘤、软骨肉瘤、纤维脂肪瘤、纤维血管瘤和先天性囊肿各1例。CT检查21例,其中15例作增强扫描。MRI检查31例,其中24例加作MR增强扫描。结果：肿瘤内纡曲流空的血管即“椒-盐”征是颈静脉球瘤的特征性MRI表现。神经鞘瘤易发生囊变,注射对比剂后肿瘤中度强化。转移瘤骨质破坏不规则。脑膜瘤增强扫描可见脑膜“尾巴”征。软骨瘤和软骨肉瘤可见明显钙化。结论：CT与MRI相结合能更全面地为临床提供诊断、鉴别诊断及治疗所需要的信息,为治疗方法的选择提供可靠的依据。

MRI diagnosis of tumors in jugular foramen area

Objective:To study the value of CT and MRI in the diagnosis and differential diagnosis of tumors of jugular foramen area. Methods: CT and MRI study of 34 patients with tumors of jugular foramen area were reviewed retropectively. Thirty four cases of jugular foramen area tumors underwent surgery,with pathologic confirmation,including glomus jugular tumors (n=12),jugular foramen schwannomas (n=10),metastases (n=3),meningiomas (n=2),neurofibroma (n=1),chordoma (n=1),chondroma (n=1),chondrosarcoma (n=1),fibrolipoma (n=1),fibroangioma (n=1) and congenital cyst (n=1).21 cases were evaluated with CT,among them,15 cases were examined with contrast studies by CT.Twenty four cases were examined with precontrast and postcontrast T 1 weighted MR imaging and with noncontrast T 2 weighted MR imaging.Seven were scanned without contrast study.Results:The serpiginous appearance of signal void in tumor and the "salt and pepper" sign were the characteristic MR appearance of glomus jugular tumors. Jugular foramen schwannomas could display cystic change,and showed moderate enhancement after administration of contrast medium.Bone destruction of jugular foramen area with metastases appeared irregular.Most meningiomas revealed "tail sign" after contrast enhancement.Chondroma and chondrosarcoma could show obvious calcification.Conclusion:CT combined with MRI can accurately provide all the informations regarding clinical diagnosis,treatment and reliable confidence for selecting therapeutic methods.