先天性梨状窝瘘的放射学诊断及初步分型  

Congenital pyriform sinus fistula:radiological diagnosis and preliminary classification

作　　者：杨宾[1] 乔中伟[1] 钱镔[1] 

机构地区：[1]复旦大学附属儿科医院放射科,上海201102

出　　处：《放射学实践》2011年第7期766-769,共4页Radiologic Practice

摘　　要：目的:探讨食管钡剂造影和CT扫描对先天性梨状窝瘘管临床诊断和分型的价值。方法:经手术证实的先天性梨状窝瘘患儿36例。回顾性分析其术前食管钡剂造影和/或颈部CT扫描的影像学资料,并结合手术病理结果,对其进行分型。结果:36例中,27例术前行食管钡剂造影检查者,其中25例出现梨状窝形态异常、窦道形成、窦道合并末端窦腔等征象。36例中24例术前行颈部CT扫描,包括21例CT平扫加增强扫描和3例CT平扫,其中23例患儿发现异常征象。联合CT和食管钡剂检查,术前正确诊断35例(97.2%)。进而根据CT表现和食管钡剂造影,并结合手术病理,将梨状窝瘘初步分为4型,包括梨状窝型、颈部蜂窝组织炎型、颈部肿块型和甲状腺脓肿型。结论:联合食管钡剂造影和颈部CT扫描可以提高梨状窝瘘的诊断正确率;依照影像学表现对梨状窝瘘分型,有利于正确诊断和对外科治疗方案提供合理依据。Objective：To assess the value of barium esophagography（BO） and computed tomography（CT） in the diagnosis of congenital pyriform sinus fistula（CPSF） and a preliminary classification was proposed.Methods：The BO and CT findings before surgery in thirty-six pediatric patients with surgery and pathology proven CPSF were retrospectively analyzed.The preliminary classification according to the imaging findings and pathology was worked out.Results：Of the 36 pediatric patients,27 cases underwent barium oesophagography before surgery,abnormalities including abnormal morphology of pyriform sinus,pyriform sinus fistula,sinus tract and sinus cyst were revealed in 25 patients.24 patients underwent CT scanning of neck,including 21 patients with pre-and post-contrast enhancement and 3 with non-contrast CT,23 patients showed abnormal CT findings.Using BO in combination with CT,correct diagnosis of CPSF before surgery were obtained in 35 cases.According to the radiologic and surgical findings,CPSF was preliminarily subdivided into 4 types,including pyriform sinus abnormality type,cervical cellulitis type,cervical mass type and thyroid abscess type.Conclusion：The diagnosis accuracy of CPSF could be improved by BO in combination with CT of neck,classification of pyriform sinus fistula is helpful in the diagnosis and provides reliable evidence for surgery planning.

关 键 词：先天性梨状窝瘘 食管钡剂造影 体层摄影术 X线计算机 儿童 

分 类 号：R766[医药卫生—耳鼻咽喉科]