Hong M J, Baek J H, Kim D Y, Ha E J, Choi W J, Choi Y J, Lee J H
Ultraschall Med. 2016 Oct;37(5):487-491. doi: 10.1055/s-0034-1385673. Epub 2014 Dec 17.
To evaluate the ultrasound characteristics of the spinal accessory nerve (SAN) and correlate nerve location with neck lymph node level. 50 participants with 100 SANs were enrolled in this study. The SAN was traced from the trapezius muscle to the upper neck and was identified by a hypoechoic linear structure without color Doppler flow. The ultrasound characteristics of the SAN, such as visibility, diameter, relationship with adjacent structures, and its correlation with lymph node levels, were evaluated. The SAN was identified in 96 %-100 % of segments. The mean diameter of the SAN was 0.54 ± 0.09 mm. The SANs was located between the trapezius and levator scapulae muscles and 90.8 % were traced into the trapezius muscle. In the upper neck, the SAN passed deep into the sternocleidomastoid (SCM) muscle in 38 % of cases and between the two heads of the SCM muscle in 62 % of cases. The SAN was found at neck lymph node levels II, III, IV, and V, but not I or VI. Continuous ultrasound monitoring of the SAN and its correlation with lymph node levels is possible in most patients. Our current findings may assist in the future prevention of SAN injury during ultrasound-guided procedures.
评估副神经（SAN）的超声特征，并将神经位置与颈部淋巴结水平相关联。本研究纳入了50名参与者共100条副神经。副神经从斜方肌追踪至颈部上方，通过无彩色多普勒血流的低回声线性结构进行识别。评估了副神经的超声特征，如可视性、直径、与相邻结构的关系及其与淋巴结水平的相关性。在96%-100%的节段中识别出了副神经。副神经的平均直径为0.54±0.09毫米。副神经位于斜方肌和肩胛提肌之间，90.8%的副神经追踪至斜方肌。在颈部上方，38%的情况下副神经深入胸锁乳突肌（SCM），62%的情况下位于胸锁乳突肌的两头之间。在颈部淋巴结II、III、IV和V水平发现了副神经，但在I或VI水平未发现。在大多数患者中，可以对副神经进行连续超声监测及其与淋巴结水平的相关性。我们目前的发现可能有助于未来在超声引导操作期间预防副神经损伤。
