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目的探讨CT在术前诊断颈交感神经鞘瘤(SSN)的价值。方法回顾性分析16例经手术和病理检查证实为颈交感神经鞘瘤患者的CT资料。分别对病变部位、肿块大小、边界、强化作出判断。重点分析在CT轴面上SSN与颈总、内动脉及颈内静脉的位置关系。对照研究病变的定位与手术所见。结果肿块均呈膨胀性生长,周围结构呈受压推移改变。10例表现为内密度不均,不均匀强化。6例表现为低密度区内散在不规则结节状、云团状或烟雾状高密度强化影。CT增强扫描示10例次颈总动脉移位于肿瘤的外半周的前半侧;16例次颈内动脉被推移于肿瘤的外半周的偏后侧。14例显示颈内静脉受压、变形并移位于肿瘤的外半周,颈内静脉皆移位于颈总(内)动脉的外后;动静脉相互靠近或分离不超过90°。手术中所见血管移位关系与此相一致。结论CT仍能较准确地反映颈交感神经颈总(内)动脉及颈内静脉等原有的解剖定位关系。根据典型血管移位关系对本病作出术前诊断具有一定的价值。
Objective To investigate the value of CT in the diagnosis of cervical sympathetic schwannoma (SSN) before operation. Methods The CT data of 16 patients with cervical sympathetic nerve sheath tumor confirmed by operation and pathology were retrospectively analyzed. Respectively on the lesion, mass size, border, to make judgments. Focus on the CT axial surface of the SSN and the total neck, internal carotid artery and internal jugular vein position. Control study of the location and operation of lesions seen. Results showed swelling mass growth, the surrounding structure was pressure to change. Ten cases showed uneven density, uneven enhancement. 6 cases showed low-density area scattered irregular nodular, cloud-like or smoke-like high-density enhancement film. CT enhanced scan showed 10 cases of common carotid artery in the first half of the shift of the outer half of the tumor; 16 cases of the internal carotid artery was pushed over the tumor in the lateral hemivertebra. In 14 cases, the jugular vein was compressed, deformed and shifted to the outside of the tumor. The internal jugular vein was displaced outside the common carotid artery. The arteries and veins were close to or separated from each other by no more than 90 °. Surgery seen the relationship between vascular displacement consistent with this. Conclusion CT still can accurately reflect the original cervical anatomical neck (internal) artery and internal jugular vein and other anatomical relationships. According to the typical relationship between vascular displacement preoperative diagnosis of the disease has some value.