X线下梨状隐窝下极位置测量及其临床意义

Measuring the position of inferior piriform recess through X-ray film and its clinical implicatiom

目的:观察梨状隐窝下极位置的动态变化,为临床置入高位食管内支架提供解剖学标志。方法:随机、自愿的原则对257例健康体检志愿者,在胃肠造影机下口服钡剂进行咽腔及食管造影,分别摄直立仰头位、平头位、低头位和仰卧仰头位咽腔食管造影片;通过X线片测量梨状隐窝下极与椎体相对位置。结果:直立仰头位梨状隐窝下极83.9%位于C4、C5椎体水平;直立平头位梨状隐窝下极75.9%在C5和相邻椎间盘水平;直立低头位梨状隐窝下极71.1%位于C5下1/3和C6水平;仰卧仰头位梨状隐窝下极位置79.7%位于C4和C5椎体水平。结论:临床上放置高位食管内支架时,梨状隐窝下极比椎体作为解剖学标志推断食管入口的位置更加合理、准确。

Objective： To observe the dynamic position changes of inferior piriform recess and provide the anatomic markers for placing upper esophageal stent. Methods： On the basis of random trial and voluntary principle, 257 healthy and voluntary candidates were given barium meal orally and performed pharyngography and esophagography under gastrographic machine. The hyperextension erect position, normal erect position, hyperflexion erect position and hyperextension supine position were selected respectively. The relationship of position between the inferior piriform recess and vertebral was measured through X-ray film. Results： The inferior piriform recess in hyperextension erect position mostly located at the level of C4 and C5 （83.9%）, The inferior piriform recess in normal erect position mostly located at the level of C5 and neighboring intervertebra （75.9%）; The inferior piriform recess in hyperflexion erect position mostly located at the level of lower 1/3 of Cs and C6 （71.1%）; The inferior piriform recess in hyperextension supine position mostly located at the level of C4 and C5 （79.7%）, Conclusions： It is a more reasonable and accurate method to judge esophageal upper orifice regarded inferior piriform recess as anatomic marker than vertebra as anatomic marker when performing esophagography or placing upper esophageal stent.