颈部淋巴结的CT分区诊断二病房•Ⅰ区: 为颌下及颏下淋巴结 • Ⅰ a 颏下淋巴结 • Ⅰ b 颌下淋巴结 •Ⅱ区: 位于颈内静脉周围，由二腹肌后腹－ 舌骨水平 •Ⅱ a 副神经之前的淋巴结Ⅱ b 副神经之后 的淋巴结•Ⅲ区：位于舌骨下缘－环状软骨下缘之间的颈 内静脉周围； •Ⅳ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；•Ⅴ区：颈后三角区，胸锁乳头肌后缘、斜方 肌前缘的三角区; •Ⅵ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 •Ⅶ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Ⅰ-Ⅵ区以淋巴结最大横径 ≥１５ｍｍ，纵隔（Ⅶ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 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: 1a 1b 2a 2b 3 4 5 6 RPbetween pharyngeal muscles 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: 1a 1b 2a 2b 3 4 5 6 RPmedial to anterior bellies of digastric muscleslateral to anterior bellies of digastric muscles back to posterior edge of submandibular glandfrom back of SM gland to back of IJ deep 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: 1a 1b 2a 2b 3 4 5 6 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会厌前间隙nodal stations: 1a 1b 2a 2b 3 4 5 6 RP(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: 1a 1b 2a 2b 3 4 5 6 RParytenoidstranvs/obliq arytenoid mlaryngeal 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: 1a 1b 2a 2b 3 4 5 6 RPmanubrium to bottom of thyroid cart., medial to SCM, thyroid glandcricoidthyroid glandstraps SCMcarotidsIJslongus colliscalenestrachea esophagus第七层次定位标志 1 环状软骨nodal stations: 1a 1b 2a 2b 3 4 5 6 RPbelow 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: 1a 1b 2a 2b 3 4 5 6 RPends 2 cm above sternoclav jointends at manubrium•1 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。