【摘要】 目的评价咽旁间隙肿瘤手术中CT血管造影(CTA)的应用价值。方法对41例咽旁间隙肿瘤患者采用CTA检查,容积再现法(VRT)和最大密度投影法(MIP)重建图像,分析肿瘤、血管和颈椎骨之间的三维空间关系,选择理想的手术入路。结果所有肿瘤灶均被CTA所显示,并显示了肿瘤的部位、大小、形态、轮廓的三维结构,CTA特别清晰地显示了肿瘤对颈部血管的压迫移位情况,这些资料均被手术所证实。40例手术治疗:2例神经鞘瘤术后出现声音沙哑并呛咳,分别于术后2个月和半年恢复;其余病例未出现明显神经损伤症状及血管损伤等并发症,术后伤口愈合良好,随访半年～7年无复发。结论 CTA对咽旁间隙肿瘤术前评估有其重要的临床应用价值,尤其适合于血供丰富的实质性肿瘤,有助于手术入路的设计。更多还原

【Abstract】 Objective To evaluate the application of CT angiography(CTA) in surgical treatment of parapharyngeal space tumors.Methods CTA examination was performed in 41 patients with parapharyngeal space tumors.The 3D spatial relationship among tumor,blood vessel and cervical vertebrae was analyzed by using volume rendering(VRT) and maximum intensity projection(MIP) reconstruction to select optimal surgical approach.Results The CTA displayed tumor foci and 3D structures of tumor location,size,shape and contour,especially neck vessel translocation caused by tumor oppression.These data were confirmed by surgery.Among the 40 patients treated with operation,hoarseness and cough occurred after operation for schwannoma in 2 patients,who recovered 2 and 6 months after operation,respectively.No nerve damage,vascular injury and other complications were found in the other 38 patients and wounds healed well after operation.No recurrence was observed after 6 months to 7 years of follow-up.Conclusion The CTA has considerable value in preoperative assessment of parapharyngeal space tumors and contribute to the design of surgical approach,especially in solid tumors with rich blood supply.更多还原