摘要:目的:通過食管吞鋇造影及造影后CT平掃檢查提高梨狀窩瘺的診斷率。方法:平臥位左、右、前、后斜位和頭低足高位食管吞鋇后透視觀察有無鋇劑外漏后,行CT平掃檢查。掃描范圍上起口咽部,下至胸骨上窩,層距厚3 mm。掃描后圖像作多層面重建處理。結果:透視下見到瘺管3例,另3例經CT多層面重建隱約見到瘺管,但14例均可見漏出的鋇劑滯留影,可判斷瘺管的存在。結論:食管吞鋇造影及造影后CT平掃可提高對梨狀窩瘺診斷的敏感性和診斷率。Abstract: Objective: To improve the diagnosis rate of the pyriform sinus fistula by means of esphagogram and CT scan after esphagogram. Methods:To observe whether there is the leakage of barium by Xray check after barium swallowed in the five positions of body, followed by CT scan. The scanning ranges from oropharyngeal to Waterloo on sternum. The thickness is 3mm. The image is dealt with multidimensional reconstruction after the scan. Results:Among fourteen cases, the fistula can be seen in three, and be indistinctly seen after the multidimensional reconstruction of CT scan in the other three ones. All The fourteen cases show the trace of the leakage of barium, which helps to prove the existence of pyriform sinus fistula. Conclusions: Esphagogram and CT scan after esphagogram contribute the sensitivity of the diagnosis of pyriform sinus fistula, and improve the diagnosis rate.
【摘要】 目的 探討CT對嬰幼兒腹部巨大囊性病變的診斷價值及其鑒別診斷。 方法 搜集2003年-2009年間經手術病理證實的2歲以內患兒腹部巨大囊性病變62例，分析其病變部位、大小、形態、分隔、密度和強化、囊壁及與周圍臟器關系等要素。 結果 62例中，先天性膽總管囊腫4例，重度腎積水36例，巨輸尿管2例，囊性腎母細胞瘤4例，大網膜囊腫4例，腸系膜囊腫3例，卵巢囊腫6例，囊性畸胎瘤3例。 各種囊性病變有其一定的發病部位和特征性的CT表現。 結論 CT是嬰幼兒腹部囊性病變定位、定性診斷的重要影像學方法。【Abstract】 Objective To explore the value of CT diagnosis and differential diagnosis of the giant cystic lesions in abdomen of the infants. Methods A total of 62 infants younger than 2 years old with the giant cystic lesions in abdomen confirmed by surgery and histopathology from 2003 to 2009 were collected. The location of the lesion, range, configuration, thickness of cystic wall and septa, density, contrast enhancement, and adjacent organs were observed and analyzed. Results In 62 infants, there were congenital cyst of common bile duct in 4, giant hydronephrosis in 36, primary megaureter in 2, cystic Wilms tumor in 4, greater omentum cyst in 4, mesenteric cyst in 3, ovarian cystic in 6, and cystic teratoma in 3. Each disease had its own lesions location and features of CT images. Conclusion CT is very effective on the localized and qualitative diagnosis of the giant cystic lesions in abdomen of infants.
