[摘要] 目的 探討和分析超聲對(duì)于咽食管憩室的臨床診斷價(jià)值。方法 回顧性分析2005年2月—2016年9月經(jīng)彩超檢查后，通過(guò)手術(shù)、頸部CT或者X線鋇劑造影、以及胃鏡證實(shí)而確診的36例咽食管憩室患者，對(duì)其聲像圖特征進(jìn)行總結(jié)分析。結(jié)果 36例咽食管憩室，大小都處在6 mm×4 mm～18 mm×12 mm之間，位置也都處在甲狀腺左側(cè)葉的后部。經(jīng)超聲聲像檢查發(fā)現(xiàn)以下特點(diǎn)：都位于甲狀腺左側(cè)葉的后方，9例顯現(xiàn)蝌蚪形，其余以類圓形多見(jiàn)，4例較大者只能模糊的展現(xiàn)和食管壁的關(guān)系；讓受檢者做吞咽動(dòng)作之后，見(jiàn)到24例病灶和甲，狀腺之間產(chǎn)生了相對(duì)運(yùn)動(dòng)，另外12例則沒(méi)有相對(duì)運(yùn)動(dòng)；通過(guò)探頭進(jìn)行加壓后，20例外在形狀與內(nèi)部強(qiáng)回聲形狀具有顯著改變，16例沒(méi)有較大改變；在飲水與吞咽唾液后，26例病灶區(qū)內(nèi)有氣體強(qiáng)回聲現(xiàn)象與唾液現(xiàn)象、或是病灶區(qū)內(nèi)的點(diǎn)狀強(qiáng)回聲現(xiàn)象顯著降低甚至徹底消除，10例沒(méi)有較大改變；采用彩色多普勒技術(shù)及B-flower技術(shù)均未顯示血流信號(hào)。結(jié)論 憩室內(nèi)點(diǎn)狀或斑片狀強(qiáng)回聲，周邊可見(jiàn)半環(huán)狀、聲暈狀低回聲與食管壁相連續(xù)，飲水后內(nèi)部回聲改變是咽食管憩室特征性超聲表現(xiàn)；超聲結(jié)合飲水試驗(yàn)多切面觀察可提高其診斷準(zhǔn)確度；采用彩色多普勒技術(shù)及B-flower技術(shù)可有效區(qū)別于甲狀腺結(jié)節(jié)（71%的甲狀腺結(jié)節(jié)可顯示其周邊及或內(nèi)部血流信號(hào)）。這對(duì)該病的診斷及與甲狀腺結(jié)節(jié)的有效鑒別診斷會(huì)產(chǎn)生極大的意義。
　　[關(guān)鍵詞] 超聲檢查；咽食管憩室；飲水實(shí)驗(yàn)
　　[中圖分類號(hào)] R445 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-0742（2018）01（c）-0025-03
　　[Abstract] Objective This paper tries to investigate and analyze the clinical value of ultrasonography in the diagnosis of pharyngeal and esophageal diverticulum. Methods From February 2005 to September 2016， 36 cases of pharyngoesophageal diverticulum diagnosed by color Doppler ultrasonography after surgery， neck CT or radiography， and gastroscopy were retrospectively reviewed to summarize their sonographic features. Results 36 cases of pharyngeal esophageal diverticulum， the size was between 6 mm×4 mm～18 mm×12 mm， the location was also in the left thyroid foliage at the back. The sonographic findings revealed the following features： all located in the posterior thyroid left lobe， 9 cases showed tadpole-shaped， others were more common round-like， 4 cases of larger could only vaguely show the relationship with the esophageal wall； After the swallowing action， the seizures of 24 cases and relatives of the thyroid gland and thyroid gland were observed. In the other 12 cases， there was no relative motion. After the probe was pressurized， the external shape and internal echo shape of 20 cases were significant changed， 16 cases did not change significantly； after drinking water and swallowing saliva， there were gas hyperechoic phenomenon and saliva phenomenon in 26 cases of lesion area， or point-like hyperechoic phenomenon in lesion area was significantly reduced or even completely eliminated， 10 cases did not have large changes； using color Doppler technology and B-flower technology did not show the blood flow signal. Conclusion Diverticulum punctate or spot-like hyperechoic， around the visible semi-annular sound hypoechoic echo and esophageal wall continuous after drinking water， the internal echo is pharyngeal esophageal diverticulum characteristic ultrasound； ultrasound combined with drinking water test multi-slice observation can improve its diagnostic accuracy； using color Doppler technology and B-flower technology can be distinguished from thyroid nodules （71% of thyroid nodules can show peripheral and / or internal blood flow signals）. This diagnosis of the disease and the effective identification of thyroid nodules will have a great significance.

相關(guān)熱詞搜索：食管 超聲 臨床 診斷 價(jià)值