头颈部副神经节瘤的影像表现及病理特征朱芸，徐鹤,谢宗玉蚌埠医学院第一附属医院放射科蚌埠医学院医学影像学院安徽蚌埠233004$摘要】目的探讨头颈部副神经节瘤的影像表现及病理特征。
方法回顾性分析经病理证实的18例头颈部副神经节瘤患者的临床、病理及术前CT+MRI影像。
结果颈动脉体瘤10例，颈静脉球瘤4例，鼓室球瘤3例,迷走副神经节瘤（恶性）1例。
发生于颈动脉分叉、颈静脉球、鼓室及迷走神经的病灶平均长径分别为5.0cm,3.6cm,1.5cm,5.8cm,差异有统计学意义（F=6.911,P=0.008）。
病灶多为椭圆形，边缘不光滑，包膜不完整（CT主要表现为软组织肿块影，动脉期明显强化17例，中度强化1例，静脉期强化程度有所下降（TWI为等、低信号,T2WI为等或稍高信号，颈动脉体瘤、颈静脉球瘤及迷走副节瘤多有流空血管影,鼓室球瘤通常无流空血管影，差异有统计学意义（P<0.05）。
免疫组化显示Syn、S-100蛋白、CgA、NSE、CD56、Vimentin、CK阳性百分率分别为100.0%、88.9%、83.3%、72.2%、77.8%、42.1%、0.0%（17例良性副神经节瘤的K77均为低表达,1例恶性病灶K77阳性表达率高达30.0%o结论头颈部副神经节瘤的临床特点及影像表现因发病部位不同而异，若发现边缘不光滑、明显强化，伴有流空血管影的病灶,且免疫组化Syn和CgA指标阳性可帮助确诊,K77高表达可能与肿瘤的恶性程度有一定的相关性（$关键词】副神经节瘤;体层摄影术,X线计算机;免疫组化中图分类号:R739.91&R814.42文献标识码:A文章编号：1006-9011（2020）11-1988-05Imaging findings and pathological features of head and neck paragangliomaZHU Yun,XU He,XIE ZongyuDepartment of Radiology,The First Affiliated Hospital of Bengbu Medical College,Bengbu233004,P.R.China,Abstract]Objective To investigate the imaging features and patholovicai features of head and neck parayanglioma.Methods Retrospective analysis of elinicai,patholovicai and preoperahvv CT,MRI imayet of18pahentt with head and neck parayan-glioma confirmed by pathology.Results Of the18patients,10were carotid body tumort,4were Glomut jugular tumort,3were Glomut tympanic tumort,and1wat vayai parayanglioma(malignant).The average length and diametee of the lesions occurred in carotiV bifurcation,juguloe bulb,tympanic and vagus nerve were5.0cm,3.6cm, 1.5cm and5.8cm,respectively.The dimer-encc was statisticall y significant(F=6.911,P=0.008).Most of the lesions were oval,the edge was not smooth and the capsule was incomplete.The main manifestation of CT was soft tissue mass.On contrast enhanced scan,17cases were obviously enhanced in arterial phase,1case was moderately enhanced,and the dearee of enhancement in venous phase was decreased.On T WI,low signal intensity,moderate oe slightly high sicnol intensith o n T2 WI,Most of MRI superioe caro/a body tumors,juguloe buibaLiumoLsand eagaipaagangioomahad empiyeascuiaLshadow,and iympanocbuibaLiumoLusua i y had noempiyeascuiaL shadow,the dCferencc was statistically sicnificant(P<0.05).The immunohistochemicyl results showed that the positive rates of Syn,S-100protein and CgA,NSE,CD56,Vimentin,CK were100.0%,88.9%,83.3%,72.2%,77.8%,42.1%,0.0%,respectively.The expression of Ki-67in17cases of benicn parayanglioma was low,and the positive rate of Ki-67in1case of ma—vnant parayanglioma was os high os30%.Conclrsion The clinical features and imaying findings of parayanglioma of head and neck eaeyaccoedongioiheiocaioon oeihedoeaUe.IeiheedgeonoiUmooih,iheedgeoobeoouUiyenhanced,and iheie-sion is accompanied by empth vessel shadow,and the positive indexes of Syn and CgA can help te diagnose the disease.High ex-pee s oon oeKo-67maybeeeiaied ioihemaiognanidegeeeoeiheiumoe.,Key words]Parayanglioma；Tomography,X-ray computed；Immunohistochemical头颈部副神经节瘤少见，其血供丰富,如果在术作者简介:朱芸（1988-）,女，安徽泗县人，毕业于蚌埠医学院，住院医师，主要从事医学影像诊断工作通信作者:谢宗玉副主任医师E-mail:zongyuxie@ 前无法准确做出诊断，评估肿瘤与周围组织的关系,手术过程中可能会损伤血管及神经，导致大出血甚至死亡。
