Radiologia via AEREA

7/22/2019 Radiologia via AEREA

1/34

Anestesiologa y ReanimacinUniversidad de Antioquia

anestesiaudea.googlepages.com


2/34

Enfermedades degenerativasEnfermedades degenerativas a ormac ones cong n tasa ormac ones cong n tas

CarcinomasCarcinomasAlteracin de la ATMAlteracin de la ATM


3/34

Habilidad de la apertura oral.Habilidad de la apertura oral.

Desplazamiento de la via areaDesplazamiento de la via area

lesin.lesin.

..Relacin masaRelacin masa grandes vasos.grandes vasos.


4/34

a ogra as.a ogra as.

Resonancia Magntica NuclearResonancia Magntica Nuclear


5/34

Es acio Parafarn eo PPSEs acio Parafarn eo PPS

Espacio Mucosa Faringea (PMS)Espacio Mucosa Faringea (PMS) Espacio Parotdeo (PS)Espacio Parotdeo (PS) Espacio aroti eoEspacio aroti eo

Espacio Masticador (MS)Espacio Masticador (MS) Espacio Prevertebral (PVS)Espacio Prevertebral (PVS) Cavidad oral OCCavidad oral OC Espacio Sublingual (SLS)Espacio Sublingual (SLS) Espacio Submandibular (SMS)Espacio Submandibular (SMS)


6/34

linfoidelinfoide ase e cr neo as a e pa a ar an oase e cr neo as a e pa a ar an o


7/34

Base del craneo a fasciaBase del craneo a fascial n m n i l r l n m n i l r

Grasa y vasosGrasa y vasos

san uineos.san uineos.

NerviosNervios

Glandulas SalivaresGlandulas Salivaresmenoresmenores


8/34

FOSAFOSA

INFRATEMPORALINFRATEMPORAL Lobulo profundoLobulo profundo

g.paroti as.g.paroti as.

Rama del maxilar.Rama del maxilar. uscu os p er go eos.uscu os p er go eos. Musculo temporal.Musculo temporal.

max.interna y V3max.interna y V3

Linfaticos.Linfaticos.


9/34

(CAROTIDEO)(CAROTIDEO) Ar ri r iAr ri r i

interna.interna. Vena u ular interna.Vena u ular interna. Nervios Craneales: IX ,Nervios Craneales: IX ,

X , XIIX , XII Cadenas simpticas.Cadenas simpticas.


10/34

Lengua y piso de la boca.Lengua y piso de la boca. ase e a engua.ase e a engua.

Orofaringe.Orofaringe. AmgdalasAmgdalas

Espacio submandibularEspacio submandibular


11/34

COMPARTIMIENTOS CABEZA YCOMPARTIMIENTOS CABEZA Y

.. Espacio SubmandibularEspacio Submandibular spac o ara ar ngeo.spac o ara ar ngeo.

COMPARTIMIENTO INFRAHIODEOCOMPARTIMIENTO INFRAHIODEO.. Espacio pretraqueal:Espacio pretraqueal:Desde el hioides alDesde el hioides al

mediastino anterior rodea la tr uea.mediastino anterior rodea la tr uea. Espacio retrofarngeo, danger space yEspacio retrofarngeo, danger space y


12/34


13/34

Evaluar tumores derivados de mucosas.Evaluar tumores derivados de mucosas. e ac on e a masae ac on e a masa ana om a .ana om a .

Cortes 3Cortes 3--5mm, medios de contraste.5mm, medios de contraste.Coronales:Lengua, piso de la boca ,Coronales:Lengua, piso de la boca ,

trigono retromolar, mandibula.trigono retromolar, mandibula.


14/34

Laringe y cuelloLaringe y cuellon ra o eo:n ra o eo:

Carcinoma de cells escamosas.Carcinoma de cells escamosas.

Medio de contraste y cortes de 1mmMedio de contraste y cortes de 1mm..

Ventanas oseas: traumaVentanas oseas: trauma or es corona es :op m zan a v s n e aor es corona es :op m zan a v s n e a

glotis.glotis.

Tiroides y paratiroides.Tiroides y paratiroides.


15/34

. , . , . , . ,

m.masetero(m), m.pterigoideo medio (mp),espacio masticador(MS),m.milohiodeo (*),e.nasofaringeo (PMS, small arrows), e.parotideo (PS), rama mandibular(r)

e. sublingual (SL), e.submandibular (SM), paladar suave (sp), m.intrinseca lengua


16/34

internal carotid (c), epiglottis (e), genioglossus muscle (g), jugular v (J), lingual tonsil (l),

medial pterygoid muscle (mp), masticator space (MS), mylohyoid muscle (asterisk),

har n eal mucosal s ace of oro har nx small arrows , revertebral s ace PVS ,

retropharyngeal space (arrowheads), sublingual space (SL), submandibular space (SM),

submandibular gland (smg), intrinsic musculature of tongue (T), masseter muscle (m),


17/34

.

periferico. La amigdala izq. Esta aumentada El e.parafaringeo (arrow) esta lateral.


18/34

A, hiodes; B, cuerdas falsas; C, c.vocales;D tiroides. arytenoid cartilage (a), e. cervical anterior(AC), pliegues

ariepigloticos (ae), m.escaleno anterior(asm), plexo brachial (b), a.carotida (c), C.cricoide (cc), epiglotis(e),

esofago(es), hyoides(h), v.yugular(J),e. cervical posterior(PC), grasa preepiglotica(pe), g.paralaringea (pl),

e.prevertebral (PVS),e .faringeo (small arrows), m.platisma (large arrow), e.retrofaringeo(arrowheads),e.sup.cervical(SC),

m.esternocleidomastoide(scm), g.submandibular(smg), c.tiroideo(tc), tiroides(tg), traquea (tr),cuerdas vocales(tvc).


19/34

TC con contraste laringe supragloctica . A, las dos valleculas llenas de aire(V) separadas

por el pliegue glosoepiglotico medio anterior a la epiglotis(arrows).v.yugular(j), a.carotidainterna (i),arteria carotida externa (e), m.esternocleidomastoideo (s), hiodes (H) B, 8 mm

inferiores,grasa preepiglotica (PES) contrasta anteriormente con la densidad de epiglotis

. . .

(PLS). Lo pliegues ariepiglotiocs(arrowheads) separan los senos piriformes(P) y el

Vestibulo laryngeo (Ve).


20/34

RMN:SUPRAGLOTIS


21/34

CV Falsas (arrows), mediales a la gr. paraglotica

proximas a los cartilagos aritenoides (f)

El nodo tiroideo (arrowhead) esta anterior entre

.

El cartilago tiroides no calcificado,

Vena yugular(J) y arteria carotida

ver a eras w te arrow a n ve e os

Procesos vocales de los aritenoides(arrowhead)

(A), localizados superolateralalmente al borde

osterior del cartila o cricoide Cr.los te idos

blandos en la commisura anterior(black arrow)Mide normalmente menos de 2 mm


22/34

Infrahyoid retropharyngeal space and visceral space abscess. A, TC at level of false

vocal cords demonstrates low-density abscess in retropharyngeal space (arrowheads)

- .

cervical space and anteriorly into the visceral and anterior cervical spaces.

B, Communication between retropharyngeal space and mediastinum is well

demonstrated by cephalad extension of this mediastinal abscess (asterisk) posterior

to the trachea.


23/34

Transglottic laryngeal squamous cell carcinoma with vocal cord fixation. A,

True vocal cords are adducted on axial contrast-enhanced computed tomography

,

from the left true cord into adjacent paralaryngeal fat (arrow) and posteriorly intocricoarytenoid joint (arrowheads). Anterior corner of calcified left arytenoid cartilage

(asterisk) has been eroded by the tumor. B, Repeat axial CECT, performed during

qu e rea ng, revea s xa on o e e rue cor n m ne; r g cor s par a y

abducted.


24/34

Transglottic squamous cell carcinoma with cartilage invasion. Axial CECT at the true

voca cor eve s ows en anc ng mass m or g na ng n e e voca cor , cross nganterior commissure, and invading anterior third of the right cord. The tumor has

invaded through anterior thyroid cartilage and displaces thyroid strap muscles anteriorly

arrowheads .


25/34

Extrinsic tracheal compression. A, Computed tomography scan shows largemediastinal mass (M), secondary to oat cell carcinoma, compressing trachea (T) and

superior vena cava (arrow). B, In another patient with lymphoma, magnetic resonance

.


26/34


27/34


28/34

Alineacin y anatomaAlineacin y anatomaIntegridad seaIntegridad sea

Cartlago o espacio articularCartlago o espacio articularPartes BlandasPartes Blandas


29/34


30/34

Desplazamiento:alineacion l.espinolaminarDesplazamiento:alineacion l.espinolaminar nsanc am ento espac o nterpe cu ar.nsanc am ento espac o nterpe cu ar.

Rotacion apofisis espinosasRotacion apofisis espinosasCurvatura anormalCurvatura anormal


31/34


32/34

Marked thickening of the epiglottis (arrow)and aryepiglottic folds (arrowheads) is seen.

Mild hypopharyngeal overdistention is also

Retropharyngeal abscess secondary toforeign body perforation of the esophagus

The prevertebral soft tissues are markedly

present.,

anteriorly (small arrows). Large arrow

points to a metallic foreign body


33/34

Collegiate football defensive back

sustained axial loading injury to

cervical s ine while makin tacklehe was rendered a complete C5

quadriplegic A, Lateral

roentgenogram shows mild anterio

by left unilateral facet dislocation.B, CT scan with coronal

reconstruction shows significant

fractures of bodies of C5 and C6

that were not noted on lateral

roentgenogram.C,

CT scan

fractures through ipsilateral right

pedicle and lamina with free-floating

lateral mass at this level. D, CT scan through C4 and C5 shows

un atera e t-s e -5 acet s ocat on arrow . , scan w t

sagittal reconstruction shows left-sided unilateral C4-5 facet

dislocation. F, CT scan through C5 vertebral body shows significant

fractures of anterior and posterior elements and marked narrowing

. ,

significant narrowing of spinal canal resulting from retropulsed bone

and disc material. H, CT scan with contrast in subarachnoid space

shows disc material retropulsed into spinal canal to left of midline

behind bod of C4.


34/34

GRACIAS

. .

Radiologia via AEREA

Documents

Transcript of Radiologia via AEREA