胸内淋巴结定位图谱要点.pptVIP

6 5 1 2 4 3 10 8 7 9 11 Station 11 左下肺门LN 左下支气管外侧壁近背支开口，9点位置 6 5 1 2 4 3 10 8 7 9 11 3rd stage – N1 2nd stage – N2 1st stage – N3 Right sided lung lesion: Staging 6 5 1 2 4 3 10 8 7 9 11 1st stage – N3 2nd stage – N2 3rd stage – N1 Left sided lung lesion: Staging IASLC图谱 2009第七版TNM淋巴结分布图 ?锁骨上区#1下颈部、锁骨上及胸骨颈静脉切迹淋巴结 上界：环状软骨下缘 下界：双侧锁骨，正中为胸骨柄上缘 气管中线将此区域淋巴结分为1R和1L ?上纵隔区#2上气管旁淋巴结 上界：肺尖和胸膜顶，中间为胸骨柄上缘 下界：头臂静脉与气管交叉处下缘（2R）主动脉弓上缘（2L） 气管左侧缘将此区域淋巴结分为2R和2L ?上纵隔区#3血管前和气管后淋巴结 头臂干 左颈总动脉（左） 左锁骨下动脉 左头臂静脉 右头臂静脉 3a:血管前淋巴结 上界：胸膜顶 下界：隆突 前界：胸骨后 后界：上腔静脉前缘（右侧），左颈总动脉（左侧） 3p：气管后淋巴结 上界：胸膜顶 下界：隆突 上腔静脉（右） ?上纵隔区#4下气管旁淋巴结 上界：头臂静脉与气管交叉处下缘（4R），主动脉弓上缘（4L） 下界：奇静脉下缘（4R），左肺动脉干上缘（4L） 气管左侧缘为界，分为4R和4L 4R包括右侧气管旁和气管前淋巴结 4L位于气管左侧缘和动脉韧带之间 4R 4L 5 奇静脉弓 左肺动脉干 ?主动脉肺动脉区#5主动脉下和#6主动脉弓旁淋巴结 6 #5动脉韧带外侧淋巴结 上界：主动脉弓下缘 下界：左肺动脉干上缘（4L） #6升主动脉和主动脉弓前外侧淋巴结 上界：主动脉弓上缘切线 下界：主动脉弓下缘 4L 5 左肺动脉干 Station 1 * They key to success is pairing the endobronchial view and TBNA location to the CT image location. Just like in real estate, location is everything. The best technique in the world will not get results if the needle is not in the target LN. They key to success is pairing the endobronchial view and TBNA location to the CT image location. Just like in real estate, location is everything. The best technique in the world will not get results if the needle is not in the target LN. They key to success is pairing the endobronchial view and TBNA location to the CT image location. Just like in real estate, location is everything. The best technique in the world will not get results if the needle is not in the target LN. They key to success is pairing the endobronchial view and TBNA location to the CT image location. Just like in real estate, location is everything. The best technique in the world will not get results if the needle is not in the target LN. Just like in real estate, location is everything. The best technique in the world will not get results if the needle is not in the target LN. They key to succ