RADIOLOGA DE LA VA

AREA

ANA MILENA SNCHEZ PARRA

Anestesiologa y Reanimacin
Universidad de Antioquia
Medelln Colombia

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 Indicaciones
Politraumatismo
Enfermedades degenerativas
Malformaciones
M lf i congnitas
it
Carcinomas
Alteracin de la ATM
Disfuncin Columna Cervical
 Evaluacin Radiolgica
Seguridad para la intubacin.
Habilidad de la apertura oral.
Obstruccin de la VA
Desplazamiento de la via area
Evaluar extensin y profundidad de la
lesin.
Linfadenopatas.
Linfadenopatas
Relacin masa grandes vasos.
 Estudios imagenolgicos
Tomografia axial : ms til

Radiografas.
R di f

Resonancia Magntica Nuclear

 ANATOMA
Espacio
p Parafarngeo
g (PPS)
( )
Espacio Mucosa Faringea (PMS)
Espacio Parotdeo (PS)
E
Espacio
i Carotideo
C id (CS)
Espacio Masticador (MS)
Espacio Retrofaringeo (RPS)
Espacio Prevertebral (PVS)
Cavidad oral (OC)
Espacio Sublingual (SLS)
Espacio Submandibular (SMS)
 Anatomia Normal .

NASOFARINGE: mucosa respiratoria y tejido

linfoide
Base
B d
dell crneo
hasta
h t ell paladar
l d blando
bl d
 E. PARAFARINGEO:
Base del craneo a fascia
gland submandibular
Grasa y vasos
sanguineos.
g
Nervios
Glandulas Salivares
menores
 Anatomia Normal
FOSA
OS
INFRATEMPORAL
Lobulo profundo
g.parotidas.
id
Rama del maxilar.
M
Musculos
l pterigoideos.
t i id
Musculo temporal.
Ramas de la arteria
max.interna y V3
Grasa
Linfaticos.
 Anatomia Normal
PAQUETE VN
(CAROTIDEO)
Arteria Cartida
interna.
Vena yyugular
g interna.
Nervios Craneales: IX ,
X , XII
Cadenas simpticas.
 Anatomia Normal
CAVIDAD ORAL
Lengua y piso de la boca.
B
Base d
de lla lengua.
l
Orofaringe.
Amgdalas
Trigono retromolar
Espacio submandibular
 COMPARTIMIENTOS CABEZA Y
CUELLO
COMPARTIMIENTO SUPRAHIODEO.
Espacio Submandibular
Espacio
E i Parafarngeo.
P f
COMPARTIMIENTO INFRAHIODEO.
Espacio pretraqueal:
pretraqueal:Desde
Desde el hioides al
mediastino anterior,, rodea la trquea.
q
Espacio retrofarngeo, danger space y
espacio vascular
 Espacio Suprahiodeo:CT

Evaluar tumores derivados de mucosas.

Relacion
R l i de d lal masa anatomia
t i .
Cortes 3-
3-5mm, medios de contraste.
Coronales:Lengua, piso de la boca ,
g
trigono retromolar,, mandibula.
 Laringe y cuello
infrahiodeo:CT
i f hi d CT
Carcinoma de cells escamosas.
Medio de contraste y cortes de 1mm
Pruebas funcionales : m. valsalva
Ventanas oseas: trauma
Cortes
C t coronalesl :optimizan
ti i la
l visin
i i de
d la
l
glotis.
Tiroides y paratiroides.
m. digastrico(d), m.geniogloso (g), m.genihiodeo (gh), m.pterigoideo lat (lp),
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
internal carotid (c), epiglottis (e), genioglossus muscle (g), jugular v (J), lingual tonsil (l),
medial pterygoid muscle (mp), masticator space (MS), mylohyoid muscle (asterisk),
pharyngeal
p y g mucosal space
p of oropharynx
p y ((small arrows), ), prevertebral
p space
p ((PVS),
),
retropharyngeal space (arrowheads), sublingual space (SL), submandibular space (SM),
submandibular gland (smg), intrinsic musculature of tongue (T), masseter muscle (m),
Absceso amigdalas.
amigdalas TAC demuestra lesion de baja densidad(arrowheads) con anillo
periferico. La amigdala izq. Esta aumentada El e.parafaringeo (arrow) esta lateral.
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).
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.carotida
interna (i),arteria carotida externa (e), m.esternocleidomastoideo (s), hiodes (H) B, 8 mm
inferiores,grasa preepiglotica (PES) contrasta anteriormente con la densidad de epiglotis
(arrow).la g. preepiglotica extiende posterolateralmente en el e. paralaringeo(paraglottic)
(PLS). Lo pliegues ariepiglotiocs(arrowheads) separan los senos piriformes(P) y el
Vestibulo laryngeo (Ve).
RMN:SUPRAGLOTIS
CV Falsas (arrows), mediales a la gr. paraglotica
proximas a los cartilagos aritenoides (f)
El nodo tiroideo (arrowhead) esta anterior entre
Las laminas del tiroides.
El cartilago tiroides no calcificado,
Vena yugular (J) y arteria carotida

CV verdaderas
d d ( hi arrow)) a nivel
(white i ld de llos
Procesos vocales de los aritenoides(arrowhead)
(A), localizados superolateralalmente al borde
posterior del cartilago cricoide(Cr).los tejidos
blandos en la commisura anterior (black arrow)
Mide normalmente menos de 2 mm
Infrahyoid retropharyngeal space and visceral space abscess. A, TC at level of false
vocal cords demonstrates low-density abscess in retropharyngeal space (arrowheads)
creating a bow
bow-tie
tie configuration
configuration. The abscess extends laterally to the left posterior
cervical space and anteriorly into the visceral and anterior cervical spaces.
B, Communication between retropharyngeal space and mediastinum is well
demonstrated byy cephalad
p extension of this mediastinal abscess ((asterisk)) p
posterior
to the trachea.
Transglottic laryngeal squamous cell carcinoma with vocal cord fixation. A,
True vocal cords are adducted on axial contrast-enhanced computed tomography
obtained during breath holding
holding, with tumor extending anteriorly and superiorly
from the left true cord into adjacent paralaryngeal fat (arrow) and posteriorly into
cricoarytenoid joint (arrowheads). Anterior corner of calcified left arytenoid cartilage
(asterisk) has been eroded by the tumor. B, Repeat axial CECT, performed during
quiet
i tb
breathing,
thi reveals
l fifixation
ti off th
the lleft
ft ttrue cord
d iin midline;
idli right
i ht cord
d iis partially
ti ll
abducted.
Transglottic squamous cell carcinoma with cartilage invasion. Axial CECT at the true
vocall cord
d llevell shows
h enhancing
h i mass (m)
( ) originating
i i ti iin th
the lleft
ft vocall cord,
d crossing
i
anterior commissure, and invading anterior third of the right cord. The tumor has
invaded through anterior thyroid cartilage and displaces thyroid strap muscles anteriorly
(
(arrowheads). )
Extrinsic tracheal compression. A, Computed tomography scan shows large
mediastinal mass (M), secondary to oat cell carcinoma, compressing trachea (T) and
superior vena cava (arrow). B, In another patient with lymphoma, magnetic resonance
imaging shows extrinsic compression of the carina (arrows) by large mass (M).
COLUMNA CERVICAL
 Evaluacin Radiogrfica.

Alineacin y anatoma
Integridad
d d sea

Cartlago o espacio articular
Partes Blandas
 Alteraciones C. Cervical
Interrupcionde las lineas de CV Ant y post
Desplazamiento:alineacion l.espinolaminar
Ensanchamiento
E h i t espacio i interpedicular.
i t di l
Rotacion apofisis espinosas
Curvatura anormal
Anomalias integridad osea: corticales
Retropharyngeal abscess secondary to
Marked thickening of the epiglottis (arrow)
foreign body perforation of the esophagus
and aryepiglottic folds (arrowheads) is seen.
The prevertebral soft tissues are markedly
Mild hypopharyngeal overdistention is also
swollen, and the trachea is displaced
present.
anteriorly (small arrows). Large arrow
points to a metallic foreign body
 Collegiate football defensive back
sustained axial loading injury to
p
cervical spine while making g tackle;;
he was rendered a complete C5
quadriplegic A, Lateral
roentgenogram shows mild anterior
subluxation of C4 and C5 caused
by left unilateral facet dislocation.
B, CT scan with coronal
reconstruction shows significant
g
fractures of bodies of C5 and C6
that were not noted on lateral
roentgenogram. C, CT scan
through C4 vertebral body shows
fractures through ipsilateral right
pedicle and lamina with free-floating
lateral mass at this level. D, CT scan through C4 and C5 shows
unilateral
il l lleft-sided
f id d C4C4-5 facet
f dislocation
di l i (arrow).
( E CT scan with
) E, ih
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
of spinal canal
canal. G, G CT scan with sagittal reconstruction shows
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 body of C4.
GRACIAS

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