口咽部颈内动脉异位的CTA表现及临床意义

doi:10.13418/j.issn.1001-165x.2023.5.06

摘要/Abstract

摘要： 目的总结口咽部颈内动脉异位的CTA表现及临床意义。方法回顾2021年1月至2021年10月行头颈部CTA检查的363例患者临床及影像资料，对颈内动脉口咽部走形进行分析。结果发现口咽部颈内动脉异位发生率为4.96%（18例），其中右侧异位3.03%（11例），左侧1.10%（4例），双侧0.83%（3例）；变异颈内动脉距离咽壁（3.16±1.47）mm；患者多无明显局部症状，个别有咽部异物感、睡眠打鼾或吞咽梗阻感甚至发生进食短暂晕厥。结论 CTA可以清晰准确地显示口咽部颈内动脉异位，提高其检出率，为临床诊治提供影像解剖学依据。

关键词: 颈内动脉, , , 异位, , , 口咽, , , CTA

Abstract: Objective To analyze CTA manifestations of ectopic oropharyngeal internal carotid artery and its clinical significance. Methods The clinical and imaging data of 363 patients who underwent head and neck CTA from January 2021 to October 2021 were retrospectively analyzed, and the internal carotid artery form of oropharyngeal was analyzed. Results It was found that the incidence of ectopic oropharyngeal internal carotid artery was 4.96% (18 cases). Among the 18 patients, there were 3 cases of bilateral oropharyngeal internal carotid artery heterotopia, 11 cases on the right side and 4 cases on the left side. The average distance from the variant internal carotid artery to the pharyngeal wall was (3.16±1.47) mm. Most of patients had no obvious local symptom, and some had pharyngeal foreign body sensation, sleeping snoring, swallowing obstruction and transient syncope during eating. Conclusions CTA can clearly and accurately display the ectopic oropharyngeal internal carotid artery, and improve its detection rate, so as to provide anatomical basis for clinical diagnosis and treatment.

Key words: Internal carotid artery, , , Ectopic, , , Oropharynx, , , CTA

中图分类号:

韩凯. 口咽部颈内动脉异位的CTA表现及临床意义[J]. 中国临床解剖学杂志, 2023, 41(5): 531-534.

Han Kai. CTA manifestations and clinical significance of ectopic oropharyngeal internal carotid artery [J]. Chinese Journal of Clinical Anatomy, 2023, 41(5): 531-534.

参考文献 17

[1]	朱黎, 赵新湘. 双侧颈内动脉先天性缺如1例[J]. 实用放射学杂志, 2017, 33(10): 1649-1650. DOI: 10.3969/j.issn.1002-1671.2017.10.046.
[2]	Bouthillier A, Van Loveren Hr, Keller Jt. Segments of the internal carotid artery: a new classification[J]. Neurosurgery, 1996, 38(3): 425-433. DOI: 10.1097/00006123-199603000-00001.
[3]	李丽娟, 王丽, 宋昱. 颈段颈内动脉走行变异的CT表现及临床意义[J]. 中国微创外科杂志, 2011, 11(11): 1005-1007. DOI: 10.3969/j.issn.1009-6604.2011.11.016.
[4]	贾云生, 高明洋, 王焕君. 颈段颈内动脉走行变异的CT表现及临床意义[J]. 医学影像学杂志, 2016, 26(4): 592-595. CNKI: SUN:XYXZ.0.2016-04-009.
[5]	卞加伟, 黄石, 王轶. 口咽部双侧颈内动脉异位1例[J]. 中华耳鼻咽喉头颈外科杂志, 2022, 57(1): 54-56. DOI: 10.3760/cma.j.cn115330-20210518-00282.
[6]	Prokopakis Ep, Bourolias Ca, Bizaki Aj, et al. Ectopic internal carotid artery presenting as an oropharyngeal mass[J]. Head Face Med, 2008, 4: 20. DOI: 10.1186/1746-160X-4-20.
[7]	Ozgur Z, Celik S, Govsa F, et al. A study of the course of the internal carotid artery in the parapharyngeal space and its clinical importance[J]. Eur Arch Otorhinolaryngol, 2007, 264(12): 1483-1489. DOI: 10.1007/s00405-007-0398-6.
[8]	Hosokawa S, Mineta H. Tortuous internal carotid artery presenting as a pharyngeal mass[J]. J Laryngol Otol, 2010, 124(9): 1033-1036. DOI: 10.1017/S0022215110000368.
[9]	谢三林, 陈十燕, 陈贤明. 颈内动脉咽部异位2例[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(4): 328-329. DOI: 10.13201/j.issn.1001-1781.2016.04.018.
[10]	Pfeiffer J, Becker C, Ridder Gj. Aberrant extracranial internal carotid arteries: new insights, implications, and demand for a clinical grading system[J]. Head Neck, 2016, 38 Suppl 1: E687-E693. DOI: 10.1002/hed.24071.
[11]	Picel Ac, Davidson Tm. An aberrant internal carotid artery discovered during evaluation of obstructive sleep apnea: a report of 2 cases with consideration of a possible association[J]. Ear Nose Throat J, 2011, 90(1): 29-31. DOI: 10.1177/014556131109000109.
[12]	Gates Mj, Brinjikji W, Williams L, et al. Mild carotid stenosis with recurrent symptoms triggered by eating[J]. World Neurosurg, 2017, 97: 750.e11-750.e13. DOI: 10.1016/j.wneu.2016.10.097.
[13]	张剑利, 王跃建, 陈伟雄. 鼻咽癌放疗后鼻咽出血原因分析[J]. 临床耳鼻咽喉头颈外科杂志, 2010, 24(9): 394-395, 399. DOI: 10.3969/j.issn.1001-1781.2010.09.004.
[14]	Prokopakis E, Lyronis G, Kaprana A, et al. Aberrant internal carotid artery: a risky condition for tracheal intubation[J]. Intensive Care Med, 2015, 41(4): 721-722. DOI: 10.1007/s00134-014-3585-0.
[15]	KoreckijJ, AlviH, GiblyR, et al. Incidence and risk factors of the retropharyngeal carotid artery on cervical magnetic resonance imaging[J]. Spine (Phila Pa 1976), 2013, 38(2): E109-E112. DOI: 10.1097/BRS.0b013e31827b0d4b.
[16]	宋殿行, 郭鹏, 杨新国, 等. 颈内动脉发育不良的CT诊断[J]. 临床放射学杂志, 2019, 38(1): 58-62. DOI: 10.13437/j.cnki.jcr.2019.01.013.
[17]	尤云峰, 张森, 鲍伟宇, 等. 颈内动脉颈段走行异常的影像解剖研究[J]. 中国临床解剖学杂志, 2018, 36(01): 30-32, 37. DOI: 10.13418/j.issn.1001-165x.2018.01.008.