CAJ | 학술논문

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。
목적：명학경흉교계구감염、적기병변적 MDCT 영상표현특점화규률，결합시체단면해부관찰，탐토기영상학표현여해부、병이학기출적상관성。방법：관찰시체단면표본11구（5례횡단면、4례시상면화2례관상면），주요관찰경흉교계구조직결구적위치、형태특정，병결합경림상혹병리증실적경흉교계구감염、적기성병변84례적 MDCT 표현특점급규률，천명영상학표현여해부、병이학적상관성。결과：11례시체단면해부발현：인후간극、추전간극여상종격식관후간극자연상통；추전간극향외하방경액초여액와상련통；경동맥초향하여상종격혈관주위간극상연속；경부기관전간극향하여상종격상통。84례환자적 MDCT 영상표현：인후간극감염가향하체후종격；추전간극감염가향하만연지후종격，향량측만연지액와；경동맥초감염가향하연신지상종격；적기성병변가동시분포우종격、경부、액와구。결론：MDCT 능구상세반영경흉교계구감염、적기병변적국부표현화향주위확산적정황；시체단면발현적해부특점결정료차구역병조적우세분포。
Objective:To study the multi-detector CT (MDCT)appearances of infection and air collection at cervico-thoracic junction,and correlated with anatomic findings on cross-section of cadavers.Methods:11 adult 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 un-derwent MDCT were also studied and correlation with patho-anatomy was performed.Results:The main findings of 11 cada-vers were as follows:anatomic communication was revealed between retropharyngeal space and prevertebral space with ret-roesophageal space of superior mediastinum;prevertebral space extended laterally and inferiorly,communicating with axilla-ry 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 retropharyn-geal 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 de-tail 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 ca-davers.