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Preoperative Embolization of Paragangliomas and AngiofibromasMeasurement of Intratumoral Arteriovenous Shunts
Gerhard Schroth, MD;
Andreas R. Haldemann, MD;
Luigi Mariani, MD;
Luca Remonda, MD;
Joram Raveh, MD, DMD
Arch Otolaryngol Head Neck Surg. 1996;122(12):1320-1325.
Abstract
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Objective
To determine if technetium Tc 99m—labeled macroaggregated albumin selective angioscintigraphy enables estimation of microparticle-arteriovenous shunt in branchial paragangliomas and nasopharyngeal angiofibromas.
Design
Technetium Tc 99m—labeled macroaggregated albumin particles with calibrated diameters between 25 and 50 µm were administered during selective catheterization of the feeding arteries in 4 branchial paragangliomas (glomus tumors) and 4 nasopharyngeal angiofibromas. Preliminary measures of the activity of the tumor region and of the lungs were obtained in the angiography suite using a hand-held detector. Without changing the position of the microcatheter, definitive embolization was performed. After endovascular treatment, scintigraphy was performed and the pulmonary shunt index was calculated with the use of a gamma camera and a dedicated computer program.
Results
The pulmonary shunt index varied between 0% and 36% for branchial paragangliomas (glomus tumors) and between 82% and 95% for angiofibromas.
Conclusions
Our results provide new evidence that the incidence of microparticle-arteriovenous shunt in nasopharyngeal angiofibromas is much higher than in paragangliomas.
Arch Otolaryngol Head Neck Surg. 1996;122:1320-1325
Author Affiliations
From the Departments of Neuroradiology (Drs Schroth, Mariani, and Remonda), Nuclear Medicine (Dr Haldemann), and Otolaryngology, Cranio-facial/Skull Base, Facial Plastic and Reconstructive Surgery (Dr Raveh), University of Bern, Bern, Switzerland.
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