咽食管憩室的超声诊断价值

Ultrasonic Value in Zenker Diverticulum

目的分析咽食管憩室的超声声像图特征,探讨超声在诊断咽食管憩室中的价值。资料与方法回顾性分析2005-01~2014-04在解放军总医院超声科应用灰阶及彩色多普勒超声诊断为咽食管憩室的12例患者的超声表现,所有病灶均通过上消化道钡餐造影确诊。结果 12例病灶均位于甲状腺左叶的后方,边界清晰,形态规则,内部均可见强回声,彩色多普勒示病灶内未见血流信号。嘱患者做吞咽动作后发现病灶与甲状腺左叶之间的运动不同步,饮水后可见水经食管进入病灶,病灶内强回声减少甚至消失,判断病灶内强回声为气体,病灶与食管相通。超声诊断为咽食管憩室,后经上消化道钡餐造影确诊。结论咽食管憩室的超声表现主要有不均质回声病灶,形态规则,弧形强回声后伴彗星尾,可以通过观察其声像图表现并结合吞咽饮水试验动态观察病灶,确认病灶与食管相通做出正确诊断。

Purpose To analyze the ultrasonic characteristics of Zenker diverticulum, and explore the value of ultrasound in the diagnosis of Zenker diverticulum. Materials and Methods A retrospective study was carried out in 12 patients with suspected Zenker diverticulum who underwent ultrasound examination in PLA general hospital from January 2005 to April 2014. The diagnosis was further proved by upper gastrointestinal barium meal. Results All the lesions in the 12 cases were located underneath the left lobe of thyroid, and they had clear boundaries, regular shape, and visible internal hyperechogencity. CDFI showed no blood flow signal within the lesions. When the patients swallowed, the movement between the lesions and the left lobe thyroid was not synchronized. After the patients drank water, the water flowed into the lesions and the internal hyperechogencity became smaller or even disappeared. The echogeuicity showed gas in the lesions, and the lesions were interlinked with esophageal. The cases were suspected as Zenker diverticulum by ultrasound diagnosis, and were further proven by upper gastrointestinal barium meal later. Conclusion The ultrasonography of Zenker diverticulum has certain characteristics. We can observe the sonographic features carefully and combine them with the pressure test, swallowing and drinking water test to confirm the lesions interlinked with esophageal for a correct diagnosis.