Open AccessImpact of geometric concepts in Multislice CT angiography and MRI on surgical outcome of carotid body tumors
Author(s) -
Randa O. Kaddah,
Magdy Haggag,
Usama Lotfi
Publication year - 2011
Publication title -
the egyptian journal of radiology and nuclear medicine /the egyptian journal of radiology and nuclear medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.19
H-Index - 13
eISSN - 2090-4762
pISSN - 0378-603X
DOI - 10.1016/j.ejrnm.2011.09.004
Subject(s) - medicine , radiology , angiography , external carotid artery , radiological weapon , surgical planning , carotid body , multislice , internal carotid artery , carotid arteries , surgery
AbstractBackgroundCarotid body tumors (CBTs) represent a challenging problem in both diagnosis and curative treatment. MSCT angiography and MRI are established methods for CBTs diagnosis.Aim of the studyRetrospective MSCTA and MR imaging analysis were reviewed in order to get objective geometric criteria compared to operative shambling classification.Materials and methods15 CBTs cases in 14 patients (one patient had bilateral tumors) were included in this study; surgical resection was done successfully in all and surgical data analysis including Shamblin classification were revised. Their preoperative MSCT angiography and/or MR images were re-studied using geometric objective criteria including the angle of circumferential encasement (ACE) of the internal carotid artery (ICA) by the tumor, the angle of splaying (AS) of carotid bifurcation, maximum diameter in craniocaudal direction (MD), and the free distal segment (DS) of extracranial ICA above the tumor. Radiological and Surgical data analysis were compared and the results were obtained.ResultsRetrospective radiological geometric imaging analysis showed tumors tendency to have ACE less than 180° in Shamblin I, and between 180° and 270° in type II and more than 270° in type III. In a similar way, AS was less than 60° in most of type I tumors, 60° to less than 90° in type II and equal or more than 90° in type III tumors. Tumor size had limited impact on Shamblin classification and DS had its impact on decision of surgical resection and ICA revascularization, surgical data analysis revealed four cases of type I, six cases of type II and four cases of type III.ConclusionsGeometric objective criteria obtained by MSCT angiography and/or MRI are very important in preoperative planning of CBTs surgery. The degree of circumferential encasement of ICA, the angle of splaying of the carotid bifurcation are appreciable criteria predicting Shamblin type of CBTs. These objective geometric criteria had a critical impact on the surgical outcome and vascular morbidity