喉咽区超声解剖与常见病变的超声诊断

doi:10.3877/cma.j.issn.1672-6448.2023.04.002

图1 喉咽区舌骨水平自上而下横断面声像图（左）及相应的探头位置示意图（右）。图a 为舌骨横断面声像图及探头位置示意图，左侧声像图示舌骨呈弧形强回声（箭头所示）伴后方宽大声影；图b 为舌骨左侧横断面声像图及探头位置示意图，左侧声像图示左侧的舌骨大角呈弧形强回声（箭头所示）伴后方声影，其外侧为左侧颌下腺；图c 为左侧颌下腺横断面声像图及探头位置示意图，左侧声像图示声束向头侧偏转，利用颌下腺做声窗，显示左侧扁桃体，呈低回声，同时可以显示扁桃体隐窝内散在气体，呈点状及线状强回声

图2 喉咽区甲状舌骨膜水平自上而下横断面声像图（左）及相应的探头位置示意图（右）。图a为甲舌膜水平正中横断面声像图及探头位置示意图，左侧声像图示甲舌膜（箭头所示）浅方为左右对称的胸骨舌骨肌和甲状舌骨肌，其深方为会厌前间隙（加号所示）和会厌软骨（星号所示）；图b为甲舌膜水平左侧横断面声像图及探头位置示意图，左侧声像图为彩色多普勒超声显示喉上动脉（箭头所示），同时显示部分左侧甲状软骨板（虚线所示）注：SH为胸骨舌骨肌；TH为甲状舌骨肌

图3 喉咽区甲状软骨水平自上而下横断面声像图（左）及相应的探头位置示意图（右）。图a为甲状软骨水平正中横断面声像图及探头位置示意图，左侧声像图示双侧的甲状软骨板呈倒“V”的低回声（虚线所示），双侧室带（星号所示）呈稍高回声；图b为甲状软骨水平正中横断面声像图及探头位置示意图，左侧声像图示双侧声带（星号所示）呈低回声，位于双侧甲状软骨板（虚线所示）深方；图c为甲状软骨水平侧方横断面声像图及探头位置示意图，左侧声像图示透过左侧甲状软骨板（虚线所示）显示左侧室带（星号所示）；图d为甲状软骨水平侧方横断面声像图及探头位置示意图，左侧声像图示透过左侧甲状软骨板（虚线所示）显示左侧声带（星号所示），两者之间为左侧声门旁间隙，内含脂肪组织呈稍高回声，声带后方低回声为左侧杓状软骨（箭头所示），其后方含气间隙为左侧梨状隐窝（红色虚线所示）

图4 喉咽区环甲膜水平自上而下横断面声像图（左）及相应的探头位置示意图（右）。图a为环甲膜水平正中横断面声像图及探头位置示意图，左侧声像图示探头略向上偏转，声束指向头侧显示甲状软骨下缘（虚线所示），双侧声带（星号所示），及其后方杓状软骨短轴切面（箭头所示）；图b 为环甲膜水平正中横断面声像图及探头位置示意图，左侧声像图显示环甲膜（箭头所示）与双侧环甲肌（红色虚线所示低回声）；图c 为环状软骨正中横断面声像图及探头位置示意图，左侧声像图示环状软骨呈低回声（加号所示），其上可见环甲肌（红色虚线所示低回声）附着，浅方可见胸骨舌骨肌和胸骨甲状肌注：SH为胸骨舌骨肌；ST为胸骨甲状肌

图6 颈正中甲舌膜正中纵断面声像图（左）及相应的探头位置示意图（右）。左侧声像图示甲舌膜（箭头所示）头侧为舌骨短轴（星号所示），足侧为甲状软骨上缘（加号所示），深方显示会厌软骨（红色虚线所示）和会厌前间隙

图7 颈侧方甲状软骨板纵断面声像图（左）及相应的探头位置示意图（右）。图a左侧声像图显示左侧甲状软骨板（虚线所示），其浅方为胸骨舌骨肌，深方为同侧室带（星号所示）和声带（加号所示）短轴切面，喉室内可见气体强回声（箭头所示）；图b左侧声像图显示甲状软骨板（虚线所示）深方的杓状软骨长轴切面，呈棒样低回声（红色虚线所示）注：SH为胸骨舌骨肌

图8 颈正中环甲膜纵断面声像图（左）及相应的探头位置示意图（右）。图a左侧声像图为正中水平显示环状软骨短轴，头侧可见甲状软骨下缘，足侧可见第一气管软骨环短轴（星号所示），深方为气道内气体强回声界面（箭头所示），环状软骨与甲状软骨之间可显示环甲肌（红色虚线所示低回声）；图b左侧声像图为侧边水平显示左侧环状软骨板（虚线所示），毗邻甲状腺注：C为环状软骨；T为甲状软骨下缘；Thyroid为甲状腺

图9 甲状舌管囊肿超声图像。图示病变（箭头所示）与舌骨（星号所示）关系密切，位于舌骨头侧，动态观察可见病变随舌骨一起运动

图10 梨状窝瘘超声及下咽食管造影图像。图a为超声图像示左侧甲状腺及其周围低回声肿物；图b为下咽食管造影示左侧梨状窝线样造影剂外漏（箭头所示），证实为左侧梨状窝瘘注：M为肿物；Thyroid为甲状腺

图11 喉癌超声图像。图a示肿瘤位于右侧甲状软骨板深方，并突向喉腔；图b示肿瘤周围可见转移淋巴结注：M为肿瘤；LN为转移淋巴结

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Ultrasound anatomy of the laryngopharyngeal region and ultrasound diagnosis of common laryngopharyngeal lesions

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Ultrasound anatomy of the laryngopharyngeal region and ultrasound diagnosis of common laryngopharyngeal lesions