《颈部影像解剖》PPT课件.ppt

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1、颈部淋巴结的CT分区诊断,二病房,区:为颌下及颏下淋巴结。a 颏下淋巴结。b 颌下淋巴结。区:位于颈内静脉周围，由二腹肌后腹舌骨水平。a 副神经之前的淋巴结。b 副神经之后的淋巴结,区：位于舌骨下缘环状软骨下缘之间的颈内静脉周围；区：颈内静脉链下组，位于环状软骨下缘至锁骨水平的颈内静脉周围；,区：颈后三角区，胸锁乳头肌后缘、斜方肌前缘的三角区;区：中央区淋巴结。包括喉前、气管前和气管旁及气管食管沟淋巴结。区：上纵隔淋巴结；,淋巴结病变的 CT 诊断标准：在 CT 扫描一旦发现气管食管沟内淋巴结即可确定为病变性淋巴结，诊断标准：颈部-区以淋巴结最大横径，纵隔（区）以淋巴结最大横径10mm,有经验

2、的外科医师仅可以触及表浅的0.5cm大小或深部1.0cm大小的淋巴结，但对位于胸锁乳路突肌深面、气管食管沟及咽后组等深部的淋巴结却难以触及。,pterygoids,stylopharyngeus,styloid process,superior phar constr,buccinator,carotid,internal jugular,masseter,parotid,retromandib v,tonsillar pillars,parapharyngeal space,定位标志1下颌骨下缘2茎突3腮腺,第一层次,nodal stations:1a1b2a2b3456RP,between

3、 pharyngeal muscles and longus colli,定位标志1下颌骨下缘2茎突3 腮腺,platysma,submandibular glands,oropharynx,epiglottis,sup phar constrictor,carotids,IJs,SCM,retromandibular v,定位标志1颌下腺2 下颌骨下缘,第二层次,nodal stations:1a1b2a2b3456RP,medial to anterior bellies of digastric muscles,lateral to anterior bellies of digastr

4、ic musclesback to posterior edge of submandibular gland,from back of SM gland to back of IJdeep to SCM,from back of IJ to back of SCM,platysma,submandibular glands,hyoid bone,valleculae,pyriform sinuses,oropharynx,intervallecular septum,SCM,carotids,IJs,sup cornu thyroid cart,epiglottis,s phar const

5、r,trapezius,第三层次,定位标志1 舌骨,nodal stations:1a1b2a2b3456RP,from back of SCM to front of trapezius,below top of hyoid,platysma,SCM,strap mm,thyroid cart,int jugulars,carotids,vertebrals,pharyngeal constrictor,pyriform sinuses,laryngopharynx,periglottic fat,pre-epiglottic fat,aryepiglottic folds,ext jugu

6、lars,第四层次,定位标志1甲状软骨2会厌前间隙,nodal stations:1a1b2a2b3456RP,deep to SCM,below hyoid,thyroid cart,laryngeal vestibule,pyriform sinuses,false cords,arytenoids,pharyngeal constrictor,straps,SCMs,IJs,carotids,第五层次,定位标志1 甲状软骨2 室带,nodal stations:1a1b2a2b3456RP,arytenoids,tranvs/obliq arytenoid m,laryngeal adi

7、tus,vocal ligament(cord),vocalis m,thyroid cartilage,strap m,pharyngeal constrictor,SCM,carotid,IJ,EJ tributaries,vertebrals,第六层次,定位标志1 甲状软骨2 声带,nodal stations:1a1b2a2b3456RP,manubrium to bottom of thyroid cart.,medial to SCM,thyroid gland,cricoid,thyroid gland,straps,SCM,carotids,IJs,longus colli,s

8、calenes,trachea,esophagus,第七层次,定位标志1 环状软骨,nodal stations:1a1b2a2b3456RP,below cricoid,deep to SCM,SCMs,straps,carotids,internal jugulars,esophagus,thyroid,ant scalenes,middle/post scalenes,brachial plexus,第八层次,定位标志1 甲状腺2 气管,nodal stations:1a1b2a2b3456RP,ends 2 cm above sternoclav joint,ends at manubrium,1 U 形为舌骨2 V形为甲状软骨3 室带有脂肪4 声带无脂肪5 胸锁乳突肌为颈三角的定位标志6 臂丛位于前中斜角肌之间7 2a和2b淋巴结以颈内静脉的后缘为界。向下止于舌骨下缘。,3区位于舌骨下缘和环状软骨下缘之间4区位于环状软骨和胸锁关节上缘2cm之间,