Glomus Caroticum Tumors: Evaluation with CT and MRI

使用電腦斷層攝影及磁振造影評估頸動脈球瘤

張天祐(Tein-Yow Chang) ； 羅兆寶(Chao-Bao Luo) ； 凌憬峰(Jiing-Feng Lirng) ； 陳行素(Shing-Su Chen) ； 鄧木火(Michael Mu-Huo Teng) ； 郭萬祐(Wan-Yuo Guo) ； 張遵(Tsuen Chang) ； 張政彥(Cheng-Yen Chang)

《中華放射線醫學雜誌》 23卷3期 (1998/06) Pp. 99-103

摘要

頸動脈球瘤為一不常見之副神經節瘤，但卻是頭頸部副神經節瘤最好發之部位。在過去16年間我們收集14例頸動脈球瘤之開刀前電腦斷層攝影及磁振造影影像，並做回溯性分析，以確立其特殊影像表徵。14例患者其中包括9位女性5位男性。年齡15至54歲。所有病人的臨床表現均為無痛性頸部腫塊，但無合併血壓及血中氣體變化。14個頸動脈球瘤皆為電腦斷層攝影所確認。所有病灶皆位於頸動脈分叉處。於打顯影劑前，電腦斷層攝影顯示頸動脈球瘤為一橢圓形，界限良好，呈稍低或是等密度之腫瘤。於注射顯影劑後可見腫瘤有良好之加強程度，並把附近之內外頸動脈往二側推。14例於電腦斷層攝影確認之病灶，有10個腫瘤依據其位置及腫瘤加強程度可於術前被正確診斷出來。另4例大腫瘤，因其太大且顯影劑加強程度不均勻而被誤認是神經性瘤。有3例患者接受磁振造影檢查。且其頸動脈球瘤所特有之“鹽與胡椒”影像表徵是診斷頸動脈球瘤之重要發現。我們認為診斷頸動脈球瘤最重要之依據為於頸動脈分叉處發現橢圓形，界限良好，呈稍低或是等密度之腫瘤。於注射顯影劑後可見腫瘤有良好之加強程度，並把附近之內外頸動脈往二側推。同時於磁振造影可見頸動脈球瘤所特有之“鹽與胡椒”影像表徵。由於這些影像的特性，使得頸動脈球瘤可以和其他頸部腫瘤做鑑別。但電腦斷層攝影對大的頸動脈球瘤仍難與一些血管豐富之神經瘤做區分。

關鍵字

頸動脈球瘤，電腦斷層 ； 頸動脈球瘤，磁振造影

並列摘要

Glomus caroticum tumors (GCTs) are rare but are the most common paragangliomas in the head and neck. The imaging studies of 14 patients with 14 GCTs in the neck were reviewed. There were 9 women and 5 men aged between 15 and 54 years with a mean age of 38. All patients presented with palpable, painless neck masses but without associated physiological changes in hemodynamics or blood gas. CT was performed on all patients while MR was performed on three. On CT scan, the lesions were well-marginated, ovoid, isodense or slightly hypodense masses in the neck, which splayed the internal and external carotid arteries at the level of the bifurcation and showed intense enhancement following intravenous administration of contrast medium. The MR findings in three patients all revealed the characteristic ”salt and pepper” appearance of GCTs. The diagnostic possibility of GCT has to be considered when an ovoid, well-demarcated solid mass is detected within the carotid bifurcation with intense contrast enhancement on CT and vascular signal voids within the mass on MRI. However, large GCTs on CT with heterogeneous density may be misunderstood as other hypervascular neurogenic tumors.

並列關鍵字

Glomus caroticum tumors, computed tomography ； Glomus caroticum tumors, magnetic resonance imaging