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目的分析喉返神经麻痹的CT表现,探讨其解剖和病理形态变化基础,提高对其影像学表现的认识。方法搜集2001至2003年经临床诊断的喉返神经麻痹患者32例,回顾性分析CT资料。所有患者均行全颈部CT增强扫描,范围从舌骨水平到上胸部水平,层厚及间隔均为5 mm。结果喉返神经麻痹后,CT检查可出现一系列相应表现:杓会厌皱襞、杓状软骨及环杓关节前内侧移位,同侧梨状窝扩张、松弛27例(84.4%);喉室扩大16例(50.0%);声带不对称且固定11例(34.4%)等。结论喉返神经支配除环甲肌以外的所有喉内肌,其麻痹后所支配的肌肉群可以发生去神经性萎缩。CT扫描可以有效地显示其相应改变,同时有助于明确麻痹原因。
Objective To analyze the CT manifestations of recurrent laryngeal nerve paralysis and to explore the basis of its anatomical and pathological changes and to improve its understanding of imaging findings. Methods Thirty-two patients with recurrent laryngeal nerve paralysis diagnosed from 2001 to 2003 were collected, and CT data were retrospectively analyzed. All patients underwent full neck CT enhanced scanning, ranging from the hyoid level to the upper chest level, thickness and spacing were 5 mm. Results After the recurrent laryngeal nerve palsy, CT examination showed a series of corresponding appearances: shy pelvis, arytenoid cartilage and pronator medial anterior shift, ipsilateral pyriform sinus expansion and relaxation in 27 cases (84.4%); 16 cases (50.0%); vocal fold asymmetry and fixed in 11 cases (34.4%) and so on. Conclusions All the intrathoracic muscles other than the cricothyroid nucleus innervating the recurrent laryngeal nerve can denervate atrophy after the paralyzed muscle group. CT scan can effectively display the corresponding changes, and help to clarify the cause of paralysis.