儿童先天性梨状窝瘘的超声特点及误诊原因  

Ultrasound Characteristics and Misdiagnosis Causes of Congenital Pyriform Sinus Fistula in Children

作　　者：董娟 纪尧峰 张琛 秦鸣 张洁 李扬 Dong Juan;Ji Yaofeng;Zhang Chen;Qin Ming;Zhang Jie;Li Yang(Department of Ultrasound,Xuzhou Children's Hospital,Xuzhou Medical University,Xuzhou,Jiangsu 221000,China;ENT&HN Surgery the Otorhindaryngology and Head&Neck Surgery Department,Xuzhou Children's Hospital,Xuzhou Medical University,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州医科大学附属徐州儿童医院超声医学科,江苏省徐州市221000 [2]徐州医科大学附属徐州儿童医院耳鼻咽喉头颈外科,江苏省徐州市221000

出　　处：《中国超声医学杂志》2023年第9期982-985,共4页Chinese Journal of Ultrasound in Medicine

基　　金：徐州市卫生健康委医学科技创新项目(No.XWKYHT20220083)。

摘　　要：目的探讨儿童先天性梨状窝瘘的超声特点及误诊原因。方法选取收治的49例先天性梨状窝瘘患儿,均经支撑喉镜下证实,分析49例患儿的超声图像特点及误诊原因。结果49例先天性梨状窝瘘患儿,男25例,女24例,左侧44例(89.8%),右侧5例;非囊肿型40例(81.6%),其中3例处于炎症静止期,37例处于炎症感染期,超声确诊37例(确诊率92.5%),3例误诊,其中1例误诊颈部脓肿,1例误诊甲状腺占位,1例左侧误诊右侧;9例为囊肿型,其中8例(88.9%)为新生儿,超声确诊4例(确诊率44.4%),5例误诊,其中3例误诊淋巴管瘤,1例误诊单纯性囊肿,1例误诊食道囊肿。结论儿童先天性梨状窝瘘无性别差异,左侧多见;非囊肿型多见,超声诊断准确度高,囊肿型少见,以新生儿发病为主,超声诊断准确度较低,超声亦可鉴别炎症感染期及静止期,为临床治疗方式及时机的选择提供参考。Objective To explore the ultrasound characteristics and misdiagnosis causes of congenital pyriform sinus fistula in children.Methods 49 children with congenital pyriform sinus fistula were selected,all of whom were confirmed by supporting laryngoscope.The ultrasound characteristics and misdiagnosis causes of these 49 children were analyzed.Results There were 49 children with congenital pyriform sinus fistula,including 25 males and 24 females,44(89.8%)on the left side,and 5 on the right side.There were 40 cases(81.6%)of non cystic,of which 3 cases were in the inflammatory quiescent phase and 37 cases were in the inflammatory infection phase.37 cases were confirmed by ultrasound(92.5%accuracy),3 cases were misdiagnosed,of which 1 case was misdiagnosed as a neck abscess,1 case was misdiagnosed with thyroid mass,and 1 case misdiagnosed with left side misdiagnosed and right side.Among 9 cases,8 cases(88.9%)were neonates,4 cases were diagnosed by ultrasound(44.4%)and 5 cases were misdiagnosed,of which 3 cases were misdiagnosed with lymphatic vessel,1 case was misdiagnosed with simple cyst,and 1 case was misdiagnosed with esophageal cyst.Conclusions There is no gender difference in congenital pyriform sinus fistula in children,and it is more common on the left side.Non cystic type is common,the accuracy of ultrasound diagnosis is high,and cystic type is rare,mainly in newborns,and the accuracy of ultrasound diagnosis is relatively low.Ultrasound can also distinguish between inflammatory infection stage and quiescent stage,and provide reference for the selection of clinical treatment methods and opportunities.

关 键 词：超声 先天性梨状窝瘘 囊肿型 炎症感染期 炎症静止期 

分 类 号：R445.1[医药卫生—影像医学与核医学] R725[医药卫生—诊断学]