超声对咽食管憩室的诊断价值
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摘要
目的探讨超声对咽食管憩室的诊断价值。方法回顾性分析在我院健康体检行甲状腺超声检查时偶然发现的并经上消化道钡餐造影或手术证实的26例咽食管憩室患者的超声资料,总结其超声声像图特征。结果 26例病灶中25例位于左颈部,1例位于右颈部。26例憩室周边均可见类似声晕样低回声。4例憩室表现为无-弱回声为主,内部见少许点状强回声;22例憩室内部回声不均质,内见点片状杂乱强回声,部分后方伴"彗星尾征"或声影。加压后有18例可以清晰显示其与食管壁相连续。饮水后,17例病灶内可见液体流入,内部回声发生改变,9例病灶内部回声无明显变化。结论不均质回声病灶,内见点片状强回声,周边低回声环,加压后显示与食管壁相连续,饮水后内部回声改变是咽食管憩室特征性超声表现,超声结合加压及饮水后多切面扫查可提高诊断咽食管憩室的准确性,减少漏误诊。
Objective To investigate the value of ultrasound in the diagnosis of pharyngear esophageal diverticulum.Methods 26 patients with pharyngeal esophageal diverticulum accidentally discovered when the healthy check-up of thyroid ultrasound and confirmed by upper gastrointestinal barium meal or surgery in our hospital,were analyzed retrospectively,summarize the ultrasonic features.Results 25 of the 26 cases were in the left neck and 1 in the right neck.Low echo halo was observed in 26 cases of esophageal diverticulum lesions.In 4 cases,the diverticulum showed no-weak echo,and a little bit of strong echo inside.In 22 cases,the internal echogenicity was found in dots or patches,partly in the rear with "comet tail sign" or sound.After pressurization,the examination revealed that there were 26 cases of the lesion and 18 cases were clearly shown to be continuous with the wall of the esophageal tube.After drinking water,the fluid was visible in 17 cases and the internal echo changed.There was no significant change in the internal echo of the 9 cases.Conclusions The ultrasonography of diverticulum has certain characteristics.We can observe the sonographic features carefully and combine them with the pressure test,and drinking water test to Improve the accuracy of the diagnosis of the esophageal diverticulum and reduce the misdiagnosis.
Objective To investigate the value of ultrasound in the diagnosis of pharyngear esophageal diverticulum.Methods 26 patients with pharyngeal esophageal diverticulum accidentally discovered when the healthy check-up of thyroid ultrasound and confirmed by upper gastrointestinal barium meal or surgery in our hospital,were analyzed retrospectively,summarize the ultrasonic features.Results 25 of the 26 cases were in the left neck and 1 in the right neck.Low echo halo was observed in 26 cases of esophageal diverticulum lesions.In 4 cases,the diverticulum showed no-weak echo,and a little bit of strong echo inside.In 22 cases,the internal echogenicity was found in dots or patches,partly in the rear with "comet tail sign" or sound.After pressurization,the examination revealed that there were 26 cases of the lesion and 18 cases were clearly shown to be continuous with the wall of the esophageal tube.After drinking water,the fluid was visible in 17 cases and the internal echo changed.There was no significant change in the internal echo of the 9 cases.Conclusions The ultrasonography of diverticulum has certain characteristics.We can observe the sonographic features carefully and combine them with the pressure test,and drinking water test to Improve the accuracy of the diagnosis of the esophageal diverticulum and reduce the misdiagnosis.
引文
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[5]李建盛,肖萤.咽食管憩室的超声诊断及临床特点[J].中国超声医学杂志,2016,32(2):178-180.
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[2]徐京京.食管憩室的发生机制及外科治疗进展[J].中国医疗前沿,2010,5(12):13-14.
[3]KIM J,KIM Y J,KIM E K,et al.Incidentally found pharyngoesophageal diverticulum on ultrasonography[J].Yonsei Med J,2002,43(3):271-273.
[4]栗小艳,王旸,唐杰,等.咽食管憩室的超声诊断价值[J].中国医学影像学杂志,2012,22(12):912-913,917.
[5]李建盛,肖萤.咽食管憩室的超声诊断及临床特点[J].中国超声医学杂志,2016,32(2):178-180.
[6]KOMATSU M,KOMATSU T,INOVE K.Ultrasonography of Zenker′s diverticulum:special reference to differential diagnosis from thyroid nodules[J].Eur J Ultrasound,2000,11(2):123-125.
[7]刘菲菲,许永波,杨智,等.超声对咽食管憩室的诊断价值[J].中国超声医学杂志,2015,31(11):968-970.