颈部影像解剖.ppt

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,styloidprocess,superiorpharconstr,buccinator,carotid,internaljugular,masseter,parotid,retromandibv,tonsillarpillars,parapharyngealspace,定位标志1下颌骨下缘2茎突3腮腺,第一层次,nodalstations:1a1b2a2b3456RP,betweenpharyngealmusclesandlonguscolli,定位标志1下颌骨下缘2茎突3腮腺,platysma,submandibularglands,oropharynx,epiglottis,suppharconstrictor,carotids,IJs,SCM,retromandibularv,定位标志1颌下腺2下颌骨下缘,第二层次,nodalstations:1a1b2a2b3456RP,medialtoanteriorbelliesofdigastricmuscles,lateraltoanteriorbelliesofdigastricmusclesbacktoposterioredgeofsubmandibulargland,frombackofSMglandtobackofIJdeeptoSCM,frombackofIJtobackofSCM,platysma,submandibularglands,hyoidbone,valleculae,pyriformsinuses,oropharynx,intervallecularseptum,SCM,carotids,IJs,supcornuthyroidcart,epiglottis,spharconstr,trapezius,第三层次,定位标志1舌骨,nodalstations:1a1b2a2b3456RP,frombackofSCMtofrontoftrapezius,belowtopofhyoid,platysma,SCM,strapmm,thyroidcart,intjugulars,carotids,vertebrals,pharyngealconstrictor,pyriformsinuses,laryngopharynx,periglotticfat,pre-epiglotticfat,aryepiglotticfolds,extjugulars,第四层次,定位标志1甲状软骨2会厌前间隙,nodalstations:1a1b2a2b3456RP,deeptoSCM,belowhyoid,thyroidcart,laryngealvestibule,pyriformsinuses,falsecords,arytenoids,pharyngealconstrictor,straps,SCMs,IJs,carotids,第五层次,定位标志1甲状软骨2室带,nodalstations:1a1b2a2b3456RP,arytenoids,tranvs/obliqarytenoidm,laryngealaditus,vocalligament(cord),vocalism,thyroidcartilage,strapm,pharyngealconstrictor,SCM,carotid,IJ,EJtributaries,vertebrals,第六层次,定位标志1甲状软骨2声带,nodalstations:1a1b2a2b3456RP,manubriumtobottomofthyroidcart.,medialtoSCM,thyroidgland,cricoid,thyroidgland,straps,SCM,carotids,IJs,longuscolli,scalenes,trachea,esophagus,第七层次,定位标志1环状软骨,nodalstations:1a1b2a2b3456RP,belowcricoid,deeptoSCM,SCMs,straps,carotids,internaljugulars,esophagus,thyroid,antscalenes,middle/postscalenes,brachialplexus,第八层次,定位标志1甲状腺2气管,nodalstations:1a1b2a2b3456RP,ends2cmabovesternoclavjoint,endsatmanubrium,1U