Transcript Obnosne votline in orbita - vaje

RADIOLOGIJA GLAVE IN VRATU
Doc.dr.Katarina Šurlan Popovič
Študijsko leto 2011/12
Slikovno preiskovalne metode
 nativni rentgenogram (digitalni)
 računalniška tomografija
 magnetna resonanca
Nativni rentgenogram
 Watersova (okcipitomentalna) projekcija
 radiološki znaki
 zadebelitev sluznice
 zasenčenje sinusa
 tekočinski nivo
Watersova projekcija
Računalniška tomografija
 uporaba multi-slice CT
 preiskava v eni ravnini ( transverzalni)
 ostale ravnine (koronarna in sagitalna)
računalnisko rekonstruirane
 kostno in mehkotkivno okno
 manjše doze
Waters in CT obnosnih votlin
Anatomija osteomeatalnega
kompleksa
Anatomske variante
Rentgenogram orbit
Orbita-poškodba
Anatomija temporalne kosti
CT TEMPORALNIH KOSTI-NAMEN
 Prevodna gluhost-strukture zunanjega in
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srednjega ušesa
Vnetja-akutni, kronični otitis (mastoiditis)
Otoskleroza
Tumorji (holesteatom, nevrinomi)
Poškodbe (prečne, vzdolžne)
Malformacije
Anatomija vratu
 suprahyoid neck
 infrahyoid neck
 superficial layer,deep cervical fascia
 middle layer,deep cervical fascia
 deep layer,deep cervical fascia
Anatomija suprahioidnega dela
vratu
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Harnsberger et al;Diagnostic imaging HEAD AND NECK,2004
Suprahyoid neck - PPS
 without critical foramen on the skull base
 empties inferiorly into submandibular space
 fat only
 lateral displacement-PMS mass
 posterior displacement-MS mass
 medial displacement-PS mass
 anterior displacement-CS mass
 direction of displacement by SHN masses
Suprahyoid neck - PMS
 posterior basisphenoid and anterior basiocciput including
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FORAMEN LACERUM
middle layer DCF –deep margin,no fascia on surface
includes nasopharyngeal,oropharyngeal and
hypopharyngeal mucosal surfaces
mucosa,Waldeyer lymphatic ring,minor salivary
glands,opening of eustachian tube,torus
tubarius,superior levator and constrictorpalatini muscles
pharyngeal SCC, tonsilar NHL
origin of SCC
Suprahyoid neck - PMS
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Harnsberger et al;Diagnostic imaging HEAD AND NECK,2004
Infrahyoid neck-VS
 infrahyoid neck only
 from hyoid bone into mediastinum
 enclosed with middle layer DCF
 thyroid and parathyroid
glands,trachea,esophagus,recurrent laryngeal
nerves,paratracheal and pretracheal nodes
 thyroid carcinoma,parathyroid
adenoma,cervical esophageal carcinoma
Infrahyoid neck
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Harnsberger et al;Diagnostic imaging HEAD AND NECK,2004
Masticator space
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Harnsberger et al;Diagnostic imaging HEAD AND NECK,2004
Parotid space
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Harnsberger et al;Diagnostic imaging HEAD AND NECK,2004
Parotid space
Suprahyoid, infrahyoid neck-CS
 floor of jugular foramen CN9-11,hypoglossal canal
CN12 and petrous ICA canal
 made up of all 3 layers of DCF
 continues inferiorly to aortic arch
 CN9-12,internal jugular vein,internal carotid artery,
level II internal jugular nodes
 paraganglioma, CN9-12 schwannoma,neurofibroma
Carotid space
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Harnsberger et al;Diagnostic imaging HEAD AND NECK,2004
Carotid space
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Harnsberger et al;Diagnostic imaging HEAD AND NECK,2004
Suprahyoid,infrahyoid neckRPS
 lower clivus without critical foramen
 empties inferiorly into DS at T3 level
 between middle layer and deep layer DCF
 DS-danger space,posterior to RPS, continues
beyond T3 to mediastinum
 RPS and DS considered single entity
 fat, medial and lateral RPS nodes, no nodes
under hyoid bone
 RPS malignant nodal metastasis (SCCa, NHL,
systemic metastasis)
 subclinical RPS nodes
Retropharyngeal space
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Harnsberger et al;Diagnostic imaging HEAD AND NECK,2004
Retropharyngeal space
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Harnsberger et al;Diagnostic imaging HEAD AND NECK,2004
Suprahyoid and infrahyoid
neck-PVS
 from skull base to Th4 in posterior mediastinum
 2 major components-prevertebral portion of space
and paraspinal portion of space
 deep layer deep cervical fascia
 anterior part DL-DCF- redirect tumor and infection
in EPIDURAL space and blocks pharyngeal
malignancy spread
 prevertebral, scalene m.,brachial plexus roots,
phrenic nerve (C3-C5), vertebral artery and vertebral
vein.
 vertebral body metastasis,brachial plexus
schwannoma
Perivertebral space
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Harnsberger et al;Diagnostic imaging HEAD AND NECK,2004
Perivertebral space
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Harnsberger et al;Diagnostic imaging HEAD AND NECK,2004