Shin Ji Eun, Baek Jung Hwan, Ha Eun Ju, Choi Young Jun, Choi Woo Jung, Lee Jeong Hyun
†Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine *Department of Radiology, CHA University College of Medicine, Gangnam CHA Hospital, Seoul ‡Department of Radiology, Ajou University School of Medicine, Suwon, Korea.
Clin J Pain. 2015 Oct;31(10):909-13. doi: 10.1097/AJP.0000000000000184.
To evaluate the feasibility of ultrasound (US) detection of the middle cervical sympathetic ganglion (CSG).
We examined 52 consecutive patients with 104 bilateral middle CSGs. We identified middle CSG according to our sonographic assessment criteria. After finding oval-shaped hypoechoic structure on transverse scan, we verified a continuous, hypoechoic line connecting the bulbous structure at both sides. The basic US characteristics were evaluated using the size, location, relationship to the common carotid artery, and relationship to the inferior thyroidal artery.
The middle CSG was identified in 41% (43/104). The mean size of the middle CSG was 3.8±1.5 mm in width, 1.9±0.7 mm in height, and 8.7±3.2 mm in length. They were primarily located at the C6 level (41/43, 95%). Regarding the relationship with common carotid artery, 88% (38/43) were lateral type and 12% (5/43) were medial type. Regarding the relationship with the inferior thyroid artery, 34% (15/43) were anterior type, 26% (11/43) were posterior type, and 40% (17/43) were unable to access the relationship.
Direct visualization of middle CSG based on the understanding of both its location and US features may reduce complications and improve the accuracy of US-guided neck procedures.
评估超声（US）检测颈中交感神经节（CSG）的可行性。
我们对52例连续患者的104个双侧颈中CSG进行了检查。我们根据超声评估标准识别颈中CSG。在横断面上发现椭圆形低回声结构后，我们确认有一条连续的低回声线连接两侧的球根状结构。使用大小、位置、与颈总动脉的关系以及与甲状腺下动脉的关系来评估基本的超声特征。
41%（43/104）的颈中CSG被识别出来。颈中CSG的平均大小为宽度3.8±1.5毫米、高度1.9±0.7毫米、长度8.7±3.2毫米。它们主要位于C6水平（41/43，95%）。关于与颈总动脉的关系，88%（38/43）为外侧型，12%（5/43）为内侧型。关于与甲状腺下动脉的关系，34%（15/43）为前方型，26%（11/43）为后方型，40%（17/43）无法明确其关系。
基于对颈中CSG位置和超声特征的了解进行直接可视化，可能会减少并发症并提高超声引导下颈部手术的准确性。
