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目的探讨超声在小儿先天性梨状窝瘘(CPSF)诊断中的临床应用价值。方法回顾性分析32例经术后病理证实CPSF患儿的临床和影像学资料。结果 32例CPSF均为单侧发病(左侧为主),其中非感染期病例8例,术前超声诊断准确6例,超声诊断符合率为75%;感染期病例24例,术前超声诊断21例,超声诊断符合率为87.5%。非感染期CPSF的超声表现为:瘘管壁薄且光滑,管径相对较细,瘘管与周围组织分界清晰,瘘管内部回声均匀。感染期CPSF的超声表现为:瘘管管径明显增粗,壁增厚毛糙,与周围组织分界不清,内见无回声区及斑块状、点状回声,部分夹杂有气体强回声;瘘管反复感染可形成颈深部脓肿,并可累及甲状腺。结论超声不仅能清晰显示瘘管是否存在及其走向,还可以根据感染期和非感染期CPSF的不同超声表现来为临床手术时机的选择提供相关信息,因此高频超声可作为CPSF的首选检查方法。
Objective To investigate the clinical value of ultrasound in the diagnosis of pediatric congenital piriform fistula (CPSF). Methods Retrospective analysis of 32 cases of CPSF confirmed by postoperative pathology in children with clinical and imaging data. Results 32 cases of CPSF were unilateral disease (left side of the main), of which non-infection cases in 8 cases, 6 cases of preoperative ultrasound diagnosis accuracy, ultrasound diagnosis of 75%; infection in 24 cases, preoperative ultrasound diagnosis 21 cases, the coincidence rate of ultrasound diagnosis was 87.5%. Non-infected CPSF ultrasound showed: fistula thin and smooth, relatively thin diameter, fistula and the surrounding tissue is clear, uniform internal fistula echo. CPSF infection during infection showed: fistula diameter was significantly thicker, rough wall thickening, unclear boundaries with the surrounding tissue, see the echo-free area and plaque, point echo, part of the mixed with gas echo; repeated fistula Infection can form deep neck abscess, and can affect the thyroid. Conclusion Ultrasound can not only clearly show the fistula presence and direction, but also provide information about the timing of clinical surgery according to different ultrasound manifestations of infection and non-infection CPSF. Therefore, high-frequency ultrasound can be used as the first choice of CPSF.