胸腔出入口区病变的CT诊断  

CT diagnosis of thoracic inlet and outlet lesions

作　　者：赵永峰[1] 田忠祥[1] 吴刚[1] 

机构地区：[1]武警南京医院影像科,210028

出　　处：《上海医学影像》2010年第3期202-205,共4页Shanghai Medical Imaging

摘　　要：目的分析胸腔出入口区的解剖学特点,进行相应分区,旨在探讨其在CT诊断中的作用。方法胸腔出入口区患者110例,男60例,女50例,年龄4～75岁,平均年龄46.5岁。以颈部包块来诊者68例,体检发现27例,其他15例。经手术病理证实71例,临床及CT证实39例。从正常健康人群中随机抽取50例作为对照组,检测其在性别及年龄构成上与研究组比较有无显著性差异。结果胸腔出入口共分5区:Ⅰ,Ⅱ,Ⅲ,Ⅳ和Ⅴ。观察组Ⅰ区11例,全部为甲状腺病变;Ⅱ区8例,包括甲状腺病变和食管病变;Ⅲ区68例,主要是淋巴类病变,共43例,其次是神经源性肿瘤10例,其它15例;跨Ⅰ、Ⅱ、Ⅴ区病变14例,甲状腺病变13例,炎性包块仅1例;跨Ⅰ、Ⅱ、Ⅲ区病变6例,全为甲状腺病变;跨Ⅲ、Ⅳ区病变3例,全为神经源性肿瘤。结论胸腔出入口区的合理解剖分区有利于CT的诊断和鉴别诊断。Objective Based on the analysis of anatomic characteristics and subregion of thoracic inlet and outlet,the value of CT diagnosis was evaluated.Methods 110 patients in aged from 4 to 75 yeas old（average 46.5） suffered from thoracic inlet and outlet disease,including 63 cases of male and 54 cases of female（1.2：1）.Among them,there were 68 cases of the neck mass,27 cases with mass during health examination and 15 cases incidentally.71 cases were confirmed by pathologic examination,and the other 39 by the clinical feature and CT examination.The control group included 50 health persons with normal gateway of thoracic inlet and outlet,and there was no significant difference of gender and age between the control and patients groups.Results The gateway of thoracic inlet and outlet was divided into 5 subregions：Ⅰ,Ⅱ,Ⅲ,Ⅳ and Ⅴ.Pathological changes in subregion Ⅰ（11 cases） occurred in thyroid,Ⅱ（8 cases） in thyroid and esophago,Ⅲ（68 cases） in lymph（43 cases）,neurogenic tumour（10） and others（15 cases）.Pathological changes involved in subregions Ⅰ,Ⅱ and Ⅴ included 14 cases of thyroid affection and 1 case of inflammatory mass.Pathological changes involved in subregons Ⅰ,Ⅱ and Ⅲ all occurred in thyroid（6 cases）,and in subregions Ⅲ and Ⅳ all were neurogenic tumour（3 cases）.Conclusion Reasonable anatomic subregion of thoracic inlet and outlet is helpful to the lesions of CT diagnosis and differential diagnosis.

关 键 词：胸腔出入口 分区 体层摄影术 X线计算机 诊断 

分 类 号：R814.42[医药卫生—影像医学与核医学]