舌骨下颈部区课件

舌骨下颈部区 -正常解剖和病变 姜庆军 下颈区的5个解剖分区 三步法分析下颈区的病变 1、内脏间隙 2、颈动脉间隙 3、咽后间隙 4、颈后间隙 5、椎旁间隙 内容物疾病 喉 喉气囊肿 鳞癌 软骨肉瘤 下咽/食管 憩室 鳞癌 气管 癌 良性狭窄 甲状腺 甲状腺肿，胶样 囊肿 癌：乳头 桥甲炎 甲状旁腺 腺瘤-增生 胚胎残余 甲状舌管囊肿 第三腮裂囊肿 气管旁淋巴结 转移-淋巴瘤 喉返神经 麻痹 第一步：位于哪个间隙？ 第二步：源于哪个器官、组织？ 气管旁淋巴结 下咽 甲状腺 胚胎残余 第三步：图像识别（征象寻找） 原发性喉气囊肿 继发性喉气囊肿 1. The thyroglossal duct runs from the base of tongue at the foramen caecum to the thyroid gland. 2. The embryonic thyroid gland or thyroid anlage travels through the duct to reach its final normal position. Normally, the thyroglossal duct then involutes, but when the duct persists, a thyroglossal duct cyst can develop anywhere along this tract (figure). 3. The location is in the midline or paramedian. 4. 65% are located infrahyoidal, 20% suprahyoidal and 15% at the level of the hyoid. 5. Ddx: necrotic anterior cervical nodes and thrombosed jugular vein. 内容物疾病 颈动脉动脉瘤-血栓 夹层 颈内静脉血栓-血栓性 静脉炎 迷走神经神经鞘瘤 交感神经丛副神经结瘤 胚胎残余第二腮裂囊 肿 淋巴结淋巴瘤 甲状腺癌或 鳞癌转移瘤 1.Also called carotid body tumor. 2.Multiple in 4% of patients. 3.25% have a positive family history. 4.Intense enhancement on CT and MR. 5.Flow voids are frequently present. 1. 95% of all branchial cleft anomalies arise from the second branchial cleft. 2. Most common presentation: cyst, sometimes in combination with a sinus or fistula. 3. Infection indicated by increased density, septations and wall thickening. 1. Benign non-capsulated lesion arising from expanding embryonic lymph lakes that do not develop normal lymphatic drainage. 2. 90% in children 10% in young adults. May occur anywhere in the head and neck. Mostly located in posterior cervical space. 10% extend into the mediastinum. 3. High signal on T2-weighted images Signal on T1-weighted images depends on pro