颈动脉体瘤系统诊断与治疗

目的:总结颈动脉体瘤的系统诊断与治疗经验。方法:对1990年1月至2005年12月8例颈动脉体瘤患者进行了彩色多普勒(Dopp ler)超声、磁共振影像(MR I)、磁共振血管成像(MRA)、数字减影血管造影(DSA)的系统影像学特征比较及M atas试验与颈内动脉暂时性球囊阻断试验(TBO)围手术期准备,并进行了手术。结果:颈动脉体瘤影像学特征:位于颈总动脉分叉处并与其紧密相连单发性肿块,瘤体内血供丰富,瘤体使颈外动脉向前内移位、颈内动脉向后外移位,颈内外动脉分叉角度增大明显,MRA及DSA呈“Goldcup”征改变。M atas试验时间45~60 d,TBO及DSA W illis环交叉充盈检查侧支循环代偿良好,8例患者手术后痊愈出院。结论:彩色Dopp ler超声、DSA、MRA均能明确诊断颈动脉体瘤,M atas试验是颈动脉体瘤手术必要常规的术前准备,W illis环交叉充盈检查是显示大脑代偿性侧支循环建立的客观标准,TBO试验是判断颈动脉结扎的可靠方法,手术是目前治疗颈动脉体瘤的最好手段。

Systematic Diagnosis and Surgical Treatment of Carotid Body Tumor

Objective: To summarize the clinical experience in systematic diagnosis and surgical treatment of carotid body tumor(CBT).Methods: The clinical data of 8 patients with CBT treated in our hospital from 1990 to 2005 were retrospectively compared with color Doppler flow imaging(CDFI),magnetic resonance imaging(MRI),magnetic resonance angiography(MRA) and digital suntraction angiography(DSA).Preoperative preparation was taken with Matas test and temporary balloon occlusion(TBO).Results: The imaging features of 8 patients with CBT were located at the bifurcation of carotid artery.Blood supply in the tumor was abundant.Internal and external carotid arteries shifted.The bifurcation of carotid artery increased and showed "Goldcup" in DSA and MRA.Matas test time was 45 to 60 days.TBO test and cross-filling in Willis circle were showed better.No complication was found in 8 postoperative patients with CBT.Conclusion: Manifestations of CBT in CDFI,DSA and MRA have itself imaging characteristics.Preoperative preparation must be taken with Matas test.Cross-filling test in Willis circle is an objective standard to reconstruct branch blood circle in brain.TBO test is the reliable method to determine the safety of carotid ligation.Surgery treatment is still the best choice for patients with CBT at present.