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CHANGES AIGIOARHITEKTONIKI AT LARGE VASCULAR NEOPLASMS OF THE NASAL CAVITY, OKOLONOSOVYH SINUSES AND THE NASOPHARYNX

Angiografichesky research was a component of medical intravascular procedure and 34 nasal cavities sick by large vascular formations, okolonosovyh sinuses and nasopharynxes (group) have been executed at all.

Angiografichesky picture of true vascular neoplasms of a nasal cavity, okolsnosovyh sinuses, a nasopharynx and malignant tumours of this area with the expressed vascular component haraktsrizonalas expansion, deformation, change of position of branches of the external carotid supplying the centre of strengthened vascularization, the raised accumulation of a radiopaque preparation in a tumour tissue.

The basic sources of blood supply of pathological formations in the given group of patients were branches internal verhnecheljustnyh arteries. Bilateral blood supply of a neoplasm has been noted at
22 patients (64,7 %) and monolateral at 12 persons (35,3 %). To wider vnugreniej verhnecheljustnoj to an artery there corresponded area of dominating vascularization of a tumour.

The ascending pharyngeal artery only in 2 cases (5,9 %) accepted significant participation in tumour blood supply. Sources of blood supply of a tumour at two sick (5,9 %) were branches of a facial artery. Identification vstaej an external carotid has appeared impossible only in one case (2,9 %). Participation in blood supply of a widespread tumour of a nasal cavity and okolonosovyh sinuses of a branch of an internal carotid has been taped in one case (2,9 %).

Good-quality vascular formations were characterised by presence of the centre of the strengthened vascularization with a network large izvityh vessels sometimes with local expansions, without signs of the expressed arteriovenous shunting (fig. 1 and, in and). Accurate contrasting of formation it become perceptible already on 3 - 4 seconds and remained in a venous phase (fig. 1 and). Accumulation of radiopaque substance in a parenchymatous phase was neraznomernym and strengthened, reflecting degree of expression of a vascular component of a tumour. Appreciable contrasting of draining veins it was not defined.

The sizes and localisation gnperpaskuljarnznro a bathing zone corresponded to a clinical stage of disease. Prevalence of a tumour by data angiograficheskogo researches was more zones of a lesion submitted computer томоірафии at 6 patients. Youthful angiofibromas among good-quality vascular neoplasms of a nasal cavity and okolonosovyh sinuses were characterised rather by more accurate contours and uniform intensive accumulation of radiopaque substance.

Fig. 1. Angiograms right internal verhnecheljustnoj arteries X., 16 years. A youthful angiofibroma of the basis of a skull in lateral (and.) and antero • back (century) projections: and. In - an arterial phase; the expressed expansion of the basic trunk internal verhnecheljustnoj an artery is defined and its branches with formation of a zone of hypervascularization in back departments of a cavity wear:, g - a capillary phase; rspttenokontraetnos the substance collects in the form of intensively painted maculae with accurate borders without signs of arteriovenous shunting.

In g


L with

Fig. I (continuation) of an angiogram left internal verhnecheljustnoj arteries X. in a frontback projection: d - an arterial phase; it is defined moderated gipervaekuljarizatsija in the field of final bifurcations left internal verhnecheljustnoj arteries with blood supply of the left departments of a tumour; e - a capillary phase; the strengthened accumulation radiopaque veshchest VA becomes perceptible.

Malignant tumours of the given localisation were characterised larger polimorfnostju angiograficheskoj pictures. As a rule, expansion of feeding vessels and density of a vascular arterial drawing have been less expressed (fig. 2). On angiograms in a tumour zone were defined izvitye istonchennye arterial branches in a little larger quantity, in a capillary phase obmechalos moderately strengthened irregular accumulation of radiopaque substance in the form of maculae without accurate borders. The venous vascular drawing was represented practically not changed, that corresponded to moderate degree of arterial hypervascularization (fig. 2).

And

g

Gis. 2. Angiograms internal verhnecheljustnyh arteries of patient K, 30 has laid down, tsis galenoi dnaja a carcinoma of the left half of nasal cavity and okolonosovyh sinuses in lateral projections: and, - ангиоіраммьі right internal verhnecheljustnoj arteries, moderate intensifying of vascularization and accumulation of radiopaque substance which have more expressed character at the left (in,) is defined

3.1.

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A source: Pashkova Svetlana Vladimirovna. The role of angiography and embolization of the branches of the external carotid artery in the diagnosis and treatment of large vascular neoplasms of the head and neck. Thesis for the degree of candidate of medical sciences. St. Petersburg - 2007. 2007

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