高频超声结合超声造影诊断咽食管憩室的价值

卓晓英; 赵宁军; 鹿皎; 侯秀敏

摘要: 目的：探讨高频超声结合口服超声造影及经肘静脉超声造影对咽食管憩室的诊断价值。方法：采用高频超声结合两种途径超声造影检查21例咽食管憩室,总结其常规超声及超声造影声像图特征。结果：高频超声结合两种途径超声造影明确诊断21例咽食管憩室。高频超声常规声像图表现有3种:(1)类圆形低回声结节（3例，长径5-8mm）；(2)类圆形或类椭圆形低回声结节内伴点片状强回声区（4例，长径7-10mm）；(3)类圆形或类椭圆形不均匀高回声结节内伴点片状强回声区（14例，长径11-26mm）。口服超声造影典型表现：患者吞咽时，可见造影剂悬浮液形成的强回声快速通过食管腔，并从食管腔呈窄带状强回声进入病灶内，吞咽间隔强回声部分消失，部分残留于病灶内，再次吞咽强回声重复进入病灶内。经肘静脉超声造影典型表现：团注超声造影剂后，动脉早期病灶与食管壁同步增强，两者之间可见带状增强区相连。结论：咽食管憩室常规声像图特征，因憩室大小及内容物不同而有差异，两种途径超声造影声像图特征典型。应用高频超声结合两种途径超声造影检查可有效提高超声诊断准确率。

Abstract: Objective To evaluate application value of High frequency ultrasound combined with two Ways of Contrast- enhanced Ultrasound in the diagnosis Of Pharyngoesophageal diverticulum. Methods 21 cases of pharyngoesophageal diverticulum examined by high frequency ultrasound combined with two ways of contrast-enhanced ultrasound．To summarize the characteristics of conventional ultrasound and contrast- enhanced ultrasound. ResuIts High frequency ultrasound combined with two Ways of Contrast- enhanced Ultrasound can diagnose definitely the pharyngoesophageal diverticulum. There are three kinds of conventional sonogr -ams of high frequency ultrasound:(1) Round-like hypoechoic nodules(3 cases, dia -meter 5-8mm)(2)Patchy hyperechoic areas in quasi-circular or quasi-elliptical hypo -echoic nodules (4cases,diameter 7-10mm)(3)Patchy hyperechoic area in quasi-circul -ar or quasi-elliptical heterogeneous hyperechoic nodules(14cases,diameter 11-26mm). Typical manifestations of oral contrast-enhanced ultrasound:When swallowing, strong echoes of contrast medium mixture can be seen rapidly passing through the esophage -al cavity.From the esophageal cavity, a narrow band of strong echoes entered the lesion , and the strong echoes of the swallowing interval disappeared partly, and some remained in the lesion. When swallowing again, the strong echoes repeated into the lesion.Typical manifestations of contrast-enhanced ultrasound via elbow vein:After bolus injection of contrast- enhanced ultrasound, the esophageal wall and the lesion were enhanced synchronously in the early stage of the arteries, and the banded enhancement areas could be seen between the two.Conclusions There were different pharyngoesophageal diverticulum’s ultrasonogra -phic features for the size of the diverticulum and capsule contents．There is typical Contrast- enhanced Ultrasound Characteristics in Two Ways.Application of high frequency ultrasonography combined with two Ways of Contrast- enhanced Ultrasound can effectively improve the ultrasound diagnostic accuracy rate．