颈部结核3__培训课件.pptVIP

Tuberculosis in the neck hao ya jing Key Words tuberculosis [tj?,b??kj?l??s?s] n. 肺结核；结核病 larynx [l?r??ks] n. [解剖] 喉；喉头 thyroid [θa?r??d] n. 甲状腺；甲状软骨； adj. 甲状腺的；盾状的 pathogenesis [,p?θ?d??n?s?s] n. 发病机理； 发病原 Key Words haematogenous [hi:m?‘t?d?in?s] 血源性的，造血的 granulomas n.肉芽肿 mucosa [mj?kos?] n. [解剖] 粘膜 antiseptic [?nt?sept?k] adj. 防腐的，抗菌的； n. 防腐剂，抗菌剂 Introduction The purpose of this study is to describe the imaging features of tuberculous involvment in the following neck regions: larynx; thyroid gland; neck spaces. The pathogenesis and imaging findings of tuberculous involvement in the neck region will be discussed. 简介 本研究主要描述颈区域（喉、甲状腺、颈间间隙）结核病变的影像特征。讨论颈部区域结核的发病机制和影像学表现。 Larynx Pathogenesis Primary involvement is rare and occurs by direct infection of the mucosa via aerosolized particles. Secondary involvement occurs via expectoration of highly infectious sputum from the tracheo-bronchial tree, via haematogenous spread from sites other than lungs, or via lymphatic spread, which is rare. 喉 发病机制 原发性喉结核较为罕见，主要是通过雾化微粒直接感染粘膜所致。继发性喉结核是由来自气管支气管树具有高度传染性的痰、来源于肺组织以外其他部位结核的血源性播散、或是淋巴扩散所引起,而淋巴播散较为罕见。 Imaging findings CT and MRI findings in the acute stage include diffuse bilateral glottic thickening, with or without an associated mass。The commonest finding in the chronic stage is a localized lesion granuloma mimicking a mass. 影像表现 CT和MRI发现在急性期双侧声襞弥漫性增厚，伴或不伴有肿块形成。在慢性期最常见的表现是类似肿块的局部肉芽肿性病变。 Fig 1 Axial CECT of the larynx shows a large, enhancing, tumour like granulomatous mass in pre-epiglottic space (black arrow) with caseating right cervical lymph node (white arrow). 图1、喉部轴位CT图像显示，会厌前间隙可见体积较大、明显强化、类似肿瘤的肉芽肿肿块(黑色箭头)和右颈部干酪样坏死淋巴结(白色箭头)。 Thyroid Pathogenesis Tuberculous involvement of the thyroid is rare and is due to secondary involvement either by haematogenous spread, or by contiguous spread from adjacent i