颈动脉体瘤的影像学诊断和手术治疗

目的:探讨颈动脉体瘤的影像学特征和外科治疗方法。方法:回顾分析6例患者的临床资料,包括术前临床检查、影像学检查、手术方法、术后处理及随访情况。结果:1例术前行B超检查,疑为颈动脉体瘤,经双源CT检查证实;3例行CT检查,1例行MRI检查,1例CT和数字减影血管造影(DSA)检查,均明确诊断。6例颈动脉体瘤患者中,单纯肿瘤切除者1例,肿瘤及颈外动脉节段切除5例,其中2例行颈总动脉分叉部缝合修补。术后1例出现舌下神经和喉返神经损伤征象及癫痫,1例出现短期的交感神经受损征象(Horner征),余均未出现与手术相关的并发症。6例患者均临床治愈,随访2个月至7年,均无复发。结论:彩色多普勒超声、CT和MRI检查均可提供一定的诊断依据,双源CT和DSA检查是诊断颈动脉体瘤的最佳手段。手术切除是颈动脉体瘤最有效的治疗方法,术前认真准备,术中细心操作,术后加强护理,可降低脑缺血损伤和脑神经损伤的概率。

Imaging diagnosis and surgical treatment of carotid body tumor

Objective: To discuss the imaging characteristics and surgical treatment of carotid body tumor.Methods: Retrospective analyses were made of the clinical data of 6 cases of carotid body tumor,including preoperative clinical findings,imaging features,surgical approaches,postoperative complications and follow-up.Results: All the 6 cases were diagnosed as carotid body tumor,1 by color Doppler imaging and dual source CT,3 by CT scanning,1 by magnetic resonance imaging(MRI) and 1 by CT and digital subtraction arteriography(DSA).Of the six patients,1 underwent removal of the tumor only and the other 5 with resection of the external carotid artery,2 of whom received suturing of the ruptured common carotid artery.Uneventful recovery was achieved in 4 of them,while hypoglossal nerve injury,recurrent laryngeal nerve injury and epilepsy were observed in 1,and adrenergic nerve injury in the other.No reoccurrence of carotid body tumor was found during the follow-up of 2 months to 7 years.Conclusion: Color Doppler imaging,CT and MRI may contribute to the diagnosis of carotid body tumor,but dual source CT scanning and DSA are the best diagnostic options.Surgical removal is the first choice for the treatment of the tumor.