1128头颈部血管瘤及血管畸放射学实践2006年11月第21卷第11期Radi01Practice,Nov2006,Vol21,N。.11形的CT、MRI诊断头颈部影像学陈燕萍,赵军,黄晖,王劲,张雪林【摘要】目的:分析头颈部血管瘤及血管畸形的CT、MRI表现,探讨其诊断及鉴别诊断价值。方法:搜集经手术病理或DSA证实,临床及影像资料完整的47例头颈部血管瘤或血管畸形病例的资料,对其进行回顾性分析。CT检查33例,MRI检查14例。结果:海绵状血管瘤21例,T。wI呈均匀等或低信号,TzwI呈高信号,增强扫描呈中等不均匀强化并可见纡曲血管强化;CT平扫呈不均匀等密度、囊状低密度,3例可见圆点状静脉石,增强扫描轻至中等度强化,其中6例见线条状粗大纡曲血管影。蔓状血管瘤23例,病变弥漫,无明显边界。T。wI呈等信号,T:wI呈不均匀高信号,其内见粗大的流空血管影及低信号静脉石,增强扫描明显不均匀强化;CT平扫等密度,见高密度圆点状静脉石,增强明显强化,可见蚯蚓状粗大血管团。淋巴管瘤3例,边界清楚,平扫为低密度,增强扫描无明显强化。结论:CT及MRI可较好显示头颈部血管畸形,蔓状血管瘤为动静脉畸形或高流速血管畸形,影像见粗大纡曲的血管影。低流速的静脉畸形、淋巴管畸形须与头颈部其它囊性病变鉴别。【关键词】血管瘤;血管畸形;体层摄影术,X线计算机;磁共振成像【中图分类号】R814.42;R445.2;R732.2【文献标识码】A【文章编号】1000—0313(2006)1l一1128一05DiagnosticValuesofCTandMRImaginginHemangiom嬲andVascularMalf0咖ationsoftheHeadandNeckCHENYan—ping,ZHAOJun,HUANGHui,eta1.ImagingDiagnosticCenter,NanfangHospital,SouthernMedicalUniversity,Guang—zhou510515,P.R.China【Abstract】objective:ToevaluatethediagnosticvaluesofCTandMRIinheadandneckhemangiomasandvascularmalformations.Methods:TheCTandMRIscansof47casesofheman鲥omasandvascularmalformationsofheadandneck,surgicaUyprovenordiagnosedwithDSA,werecollectedandretrospectivelyreviewed.33and14ofthe47caseswereexaminedwithCTandMRIrespectively.Results:Hemangiomas(n一21)appearedasintermediatesignalintensityfocionTlWIandhighsignalintensitylesionsonT2WI,homogeneousandmediumdensityfocionCTplainscans.Postcontrastly,heman—giomasshowedintermediateenhancementwithenlargedvesselswithinoraroundthelesions.Arterio—venousmalformations(AVM,n一23)showeddiffuseandheterogeneoussignalintensitywith10wsignalvessels(becauseofflowvoidphenome—non)onbothT1WIandT2WI.0nenhancingscans,AVMsdisplayedashighlyenhancedlesionswithnumerousfeedingandefferentvessels.0nCTscans,AVMsdemonstratedasintermediatedensityfoci,accompaniedwithphlebolithssometimes,andmarkedlyenhancedaftercontrastagentinjection.Lymphaticmalformations(n=3)showed10wdensityandnon_en—hancedlesionswithclearmargins.Conclusion:CTandMRlwerehelpfulinevaluatingtheextentsandtypesofheadandneckhemangiomasasweUasvascularmalformations.0nⅣ【RI,demonstrationofflow—voidvesselsandmarkedenhancementwithenlargedandtangledvesselswerethefeaturesofAVMorhighflowspeedlesions.Lowflowspeed1esions(venousmalfor—mationorlymphaticmalformation)shouldbedistinguishedfromothercystic1esionsinheadandneck.【Keywords】Hemangioma;Vascularmalformation;Tomography,X—raycomputed;Magneticresonanceimaging头颈部软组织血管瘤及血管畸形是常见的良性病变,尤其是婴幼儿及儿童。CT、MRI在其诊断方面有重要的应用价值,对了解病变范围、病变与周围结构的关系、治疗方案的选择及随访观察等方面均有很大帮助。材料与方法回顾性搜集我院近年来经手术病理证实或DSA血管造影证实,临床及影像学资料完整的头颈部血管瘤或血管畸形病例共47例。其中,男30例,女17例,作者单位:510515广州,南方医科大学南方医院影像中心作者简介:陈燕萍(1962~),女,江苏无锡人,硕士,副主任医师,主要从事头颈部、泌尿生殖系统疾病CT、MRI诊断。年龄6~64岁,平均18岁。47例中25例为出生时即发现病灶,随年龄增大病灶渐渐增大,其中,10例曾做过局部栓塞介入治疗,6例曾行手术治疗,后病变复发。25例病灶表现呈青紫色;14例呈红色,多数压之不退色,病灶质地软,。隆起于表皮,8例有博动感。除3例合并出血有压痛外,其余均无明显压痛。手术病理证实29例,DSA血管造影证实17例,穿刺活检证实1例。其中海绵状血管瘤21例,蔓状血管瘤23例,淋巴管瘤3例,33例行CT检查.,14例行MRI检查。23例CT扫描采用西门子公司SomatomPlus或万方数据万方数据万方数据万方数据万方数据