【摘要】 目的:明确颈胸交界区感染、积气病变的MDCT影像表现特点和规律,结合尸体断面解剖观察,探讨其影像学表现与解剖、病理学基础的相关性。方法:观察尸体断面标本11具(5例横断面、4例矢状面和2例冠状面),主要观察颈胸交界区组织结构的位置、形态特征,并结合经临床或病理证实的颈胸交界区感染、积气性病变84例的MDCT表现特点及规律,阐明影像学表现与解剖、病理学的相关性。结果:11例尸体断面解剖发现:咽后间隙、椎前间隙与上纵隔食管后间隙自然相通;椎前间隙向外下方经腋鞘与腋窝相连通;颈动脉鞘向下与上纵隔血管周围间隙相延续;颈部气管前间隙向下与上纵隔相通。84例患者的MDCT影像表现:咽后间隙感染可向下达后纵隔;椎前间隙感染可向下蔓延至后纵隔,向两侧蔓延至腋窝;颈动脉鞘感染可向下延伸至上纵隔;积气性病变可同时分布于纵隔、颈部、腋窝区。结论:MDCT能够详细反映颈胸交界区感染、积气病变的局部表现和向周围扩散的情况;尸体断面发现的解剖特点决定了此区域病灶的优势分布。更多还原

【Abstract】 Objective:To study the multi-detector CT(MDCT)appearances of infection and air collection at cervicothoracic junction,and correlated with anatomic findings on cross-section of cadavers.Methods:11adult cadavers were used to study the structure and morphology characteristics of cervico-thoracic junction,with axial section(n=5),sagittal section(n=4)and coronal section(n=2).84 patients with infection or air collection(pneumatosis)at cervico-thoracic junction underwent MDCT were also studied and correlation with patho-anatomy was performed.Results:The main findings of 11 cadavers were as follows:anatomic communication was revealed between retropharyngeal space and prevertebral space with retroesophageal space of superior mediastinum;prevertebral space extended laterally and inferiorly,communicating with axillary fossa via axillary sheath;carotid sheath was continuous with perivascular space of superior mediastinum;pretracheal space of neck communicated with superior mediastinum.The MDCT findings of 84 cases showed infection of retropharyngeal space extended downward to posterior mediastinum;infection of prevertebral space extended downward to posterior mediastinum and laterally to axillary fossa;infection of carotid sheath could spread downward to superior mediastinum.Air collection in mediastinum in cases of pneumatosis could simultaneously spread to neck and axillary fossa.Conclusion:The detail information of distribution of infection or air collection in cervico-thoracic junction could be revealed clearly on MDCT.The distribution of disease depends on the specific anatomy characteristics which were showed on cross section study of cadavers.更多还原