颈部影像解剖

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 。pterygoidsstylopharyngeusstyloid processsuperior phar constrbuccinatorcarotidinternal jugularmasseterparotidretromandib vtonsillar pillarsparapharyngeal space定位标志1下颌骨下缘2茎突3腮腺第一层次nodal stations:1a1b2a2b3456rpbetween pharyngeal mus

3、cles and longus colli定位标志1下颌骨下缘2茎突3 腮腺platysmasubmandibular glandsoropharynx epiglottissup phar constrictorcarotids ijs scmretromandibular v定位标志1颌下腺2 下颌骨下缘第二层次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第三层次定位标志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第四层次定位标志1

6、甲状软骨2会厌前间隙nodal stations:1a1b2a2b3456rp(end below hyoid)deep to scm, below hyoid(ends at top of hyoid)thyroid cartlaryngeal vestibulepyriform sinusesfalse cords arytenoidspharyngeal constrictorstrapsscmsijs carotids第五层次定位标志1 甲状软骨2 室带nodal stations:1a1b2a2b3456rparytenoidstranvs/obliq arytenoid mlary

7、ngeal aditusvocal ligament (cord)vocalis mthyroid cartilagestrap mpharyngeal constrictorscmcarotid ijej tributariesvertebrals第六层次定位标志1 甲状软骨2 声带nodal stations:1a1b2a2b3456rpmanubrium to bottom of thyroid cart., medial to scm, thyroid glandcricoidthyroid glandstraps scmcarotidsijslongus colliscalenest

8、rachea esophagus第七层次定位标志1 环状软骨nodal stations:1a1b2a2b3456rpbelow cricoid, deep to scmends at bottom cricoidends at transv cervical vvscmsstrapscarotidsinternal jugularsesophagusthyroidant scalenesmiddle/post scalenesbrachial plexus第八层次定位标志1 甲状腺2 气管nodal stations:1a1b2a2b3456rpends 2 cm above sternoclav jointends at manubrium