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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有经验的外科医师仅
2、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 muscles an
3、d 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 edge o
4、f 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:1a1b2a2b3456
5、RPfrom 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甲状软骨2会厌前
6、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 mlaryngeal adi
7、tusvocal 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 colliscalenestrachea esoph
8、agus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 manubrium1 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