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Dynamic Enhancement in the Carotid Body Tumor Diagnostic Value

Author: YinZuDong
Tutor: WangGuangBin
School: Shandong University
Course: Medical Imaging and Nuclear Medicine
Keywords: Carotid body tumor Multi-slice spiral CT magnetic resonance imaging dynamic enhancement
CLC: R739.91
Type: Master's thesis
Year: 2011
Downloads: 16
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Abstract


ObjectiveAnalysis of carotid body tumor dynamic enhancement CT and MRI features, Discuss CT and MR dynamic enhancement in the diagnosis of carotid body tumor, to improve the preoperative diagnosis.Materials and methods:Collected from January 2010 to May 2011 in Shandong Provincial Hospital confirmed by pathology in 19 cases of carotid body tumor patient data. Among them, 11 males and 8 females. Aged 18 to 63 years old, average 35.3 years old.16 cases routine CT scan, dynamic contrast-enhanced scans,2 patients also underwent MRI scans:five cases of MR scanning, including dynamic contrast-enhanced 3 cases.Using 64-slice spiral CT scanner (U.S. GE Light Speed). Scan parameters: 120kV,200~300mA, thickness, spacing 5mm, Pitch 1.0,reconstruction slice thickness 0.625mm, vision 20cm×20cm. Bolus of non-ionic contrast agent (Ultravist 370mgI/ml) 60~80ml, after antecubital intravenous pressure injector (Germany missouri) injection, injection rate 4.5~5ml/s, the trigger point set at the lower edge of vertebral body C4 level, the trigger threshold 120Hu, arterial phase scanning.13~18s delay line venous phase scanning:180s line delayed phase scanning. Scan range from the level of the aortic arch to the base of the skull, all scans are used to enhance plain+dynamics.Unenhanced and enhanced scan image analysis:CT reconstruction of the original data,0.625mm thin cross-sectional image post-processing workstation incoming, respectively MPR, MIP, VR technology reconstruction. According to CT findings of the carotid body tumor location, plain and enhanced in HRCT scan images, respectively, in carotid body tumors and carotid artery circular regions of interest within the painting. The region of interest were taken three times to measure the mean CT value as the analysis of data. The measurement results paired test, compared with carotid body tumor and carotid artery between the HRCT scan, CT scan enhanced the value of the difference. Compared with unenhanced HRCT and HRCT enhance scanned images of carotid body tumor on the CT value, the same location of various regions of interest:the region of interest than the same size, measuring an area of about 10 mm2, no carotid artery plaque measurement selection forming region.MRI used by the U.S. GE Signa 3.0T superconducting MR scanner, using the head eight-channel phased array coil for scanning. All patients underwent conventional MRI imaging, including axial T1-weighted image (T1-weighted image, T1WI):TR 1750ms, TE 24ms:T2-weighted images (T2-weighted image, T2WI):TR 3280ms, TE 110ms:fluid-attenuated inversion recovery (fluid-attenuated inversion recovery, FLAIR):TR 9000ms, TE 150ms:sagittal T2-weighted images (T2-weighted image, T2WI):TR 3280ms, TE 110ms. These sequences are used:spacing 1.5mm, slice thickness 5mm, FOV 240mm×240mm, matrix 320×256. Spray with gadolinium-enhanced scan for acid meglumine (Gd-DTPA) 10ml, by the antecubital vein to 3.0ml/s injection rate, dynamic enhanced horizontal line T1WI, delay line sagittal, coronal scan,3D-TOF (time over the method) three-dimensional vascular imaging.Results:19 cases of lesions are single, in the common carotid artery bifurcation.12 cases of lesions of the internal carotid, external carotid artery angle increases, was a typical "cup-like" performance:seven cases of small lesions, carotid bifurcation point of no significant change. CT scan,13 cases of lesion density, showed equal or slightly higher density, three cases of lesion density. Enhanced arterial phase,16 cases of cancer were significantly enhanced, CT value 168.7-289.6Hu,the average 228.2Hu, degree of enhancement close to the carotid artery, lesion homogeneous enhancement in 11 cases, heterogeneous enhancement in 5 cases, clear boundary:venous phase showed that the tumor continued to strengthen further, to strengthen a lesser extent below the carotid artery, CT value 145.6—170.8Hu,the average 163.2Hu,performed for uniform enhancement. According to the HRCT scan revealed the location of carotid body tumor in the HRCT scan and enhanced scan images, a total of 106 regions of interest measured CT value. HRCT scan of carotid body tumor carotid artery CT value and no significant difference between the CT value (P>0.05):HRCT enhanced scan shows the arterial phase, venous phase density close to the carotid artery lesions, CT is lower than the carotid CT value (P<0.01),5 cases delayed scan contrast agent within the tumor subsided slowly, long lifetime compared with the carotid artery, the tumor is higher than the normal carotid artery CT of CT value (P <0.01).MR scan showed equal signal T1WI, T2WI showed a slightly higher signal, after the arterial phase dynamic contrast-enhanced lesions showed heterogeneous obviously enhanced, venous phase and delayed phase enhanced still significant, signal less homogeneous.Conclusion:Carotid body tumor of CT, MRI dynamic contrast-enhanced scan with characteristic imaging findings, significantly enhanced arterial phase, venous and delayed scans showed homogeneous enhancement. In particular, arterial phase CT scan can be a good internal and external carotid artery bifurcation angle of observation changes, to determine the relationship between the tumor and the carotid artery. The performance is easy to identify with the neck mass, the best procedure for the clinical development program to provide scientific, accurate and comprehensive imaging evidence.

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CLC: > Medicine, health > Oncology > Other parts of the tumor > Head, neck, shoulder tumor
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