頸部影像解剖

1、頸部淋巴結(jié)的ct分區(qū)診斷二病房區(qū): 為頜下及頦下淋巴結(jié)。 a 頦下淋巴結(jié)。 b 頜下淋巴結(jié)。區(qū): 位于頸內(nèi)靜脈周圍，由二腹肌后腹舌骨水平。 a 副神經(jīng)之前的淋巴結(jié)。 b 副神經(jīng)之后的淋巴結(jié)區(qū)：位于舌骨下緣環(huán)狀軟骨下緣之間的頸內(nèi)靜脈周圍；區(qū)：頸內(nèi)靜脈鏈下組，位于環(huán)狀軟骨下緣至鎖骨水平的頸內(nèi)靜脈周圍；區(qū)：頸后三角區(qū)，胸鎖乳頭肌后緣、斜方肌前緣的三角區(qū);區(qū)：中央?yún)^(qū)淋巴結(jié)。包括喉前、氣管前和氣管旁及氣管食管溝淋巴結(jié)。區(qū)：上縱隔淋巴結(jié)；淋巴結(jié)病變的 ct 診斷標(biāo)準(zhǔn)：在 ct 掃描一旦發(fā)現(xiàn)氣管食管溝內(nèi)淋巴結(jié)即可確定為病變性淋巴結(jié)，診斷標(biāo)準(zhǔn)：頸部-區(qū)以淋巴結(jié)最大橫徑，縱隔（區(qū)）以淋巴結(jié)最大橫徑10mm有經(jīng)驗(yàn)

2、的外科醫(yī)師僅可以觸及表淺的0.5cm大小或深部1.0cm大小的淋巴結(jié)，但對(duì)位于胸鎖乳路突肌深面、氣管食管溝及咽后組等深部的淋巴結(jié)卻難以觸及 。pterygoidsstylopharyngeusstyloid processsuperior phar constrbuccinatorcarotidinternal jugularmasseterparotidretromandib vtonsillar pillarsparapharyngeal space定位標(biāo)志1下頜骨下緣2莖突3腮腺第一層次nodal stations:1a1b2a2b3456rpbetween pharyngeal mus

3、cles and longus colli定位標(biāo)志1下頜骨下緣2莖突3 腮腺platysmasubmandibular glandsoropharynx epiglottissup phar constrictorcarotids ijs scmretromandibular v定位標(biāo)志1頜下腺2 下頜骨下緣第二層次nodal stations:1a1b2a2b3456rpmedial to anterior bellies of digastric muscleslateral to anterior bellies of digastric musclesback to posterior

4、 edge of submandibular glandfrom back of sm gland to back of ijdeep to scmfrom back of ij to back of scmplatysmasubmandibular glandshyoid bonevalleculaepyriform sinusesoropharynxintervallecular septumscmcarotidsijssup cornu thyroid cartepiglottiss phar constrtrapezius第三層次定位標(biāo)志1 舌骨nodal stations:1a1b2

5、a2b3456rpfrom back of scm to front of trapezius, below top of hyoidends at top of hyoidall end at bottom of hyoidplatysma scmstrap mmthyroid cartint jugularscarotidsvertebralspharyngeal constrictorpyriform sinuseslaryngopharynxperiglottic fatpre-epiglottic fataryepiglottic foldsext jugulars第四層次定位標(biāo)志1

6、甲狀軟骨2會(huì)厭前間隙nodal stations:1a1b2a2b3456rp(end below hyoid)deep to scm, below hyoid(ends at top of hyoid)thyroid cartlaryngeal vestibulepyriform sinusesfalse cords arytenoidspharyngeal constrictorstrapsscmsijs carotids第五層次定位標(biāo)志1 甲狀軟骨2 室?guī)odal stations:1a1b2a2b3456rparytenoidstranvs/obliq arytenoid mlary

7、ngeal aditusvocal ligament (cord)vocalis mthyroid cartilagestrap mpharyngeal constrictorscmcarotid ijej tributariesvertebrals第六層次定位標(biāo)志1 甲狀軟骨2 聲帶nodal stations:1a1b2a2b3456rpmanubrium to bottom of thyroid cart., medial to scm, thyroid glandcricoidthyroid glandstraps scmcarotidsijslongus colliscalenest

8、rachea esophagus第七層次定位標(biāo)志1 環(huán)狀軟骨nodal stations:1a1b2a2b3456rpbelow cricoid, deep to scmends at bottom cricoidends at transv cervical vvscmsstrapscarotidsinternal jugularsesophagusthyroidant scalenesmiddle/post scalenesbrachial plexus第八層次定位標(biāo)志1 甲狀腺2 氣管nodal stations:1a1b2a2b3456rpends 2 cm above sternoclav jointends at manubrium