O'Keeffe F N, Stansberry S D, Swischuk L E, Hayden C K
Department of Radiology, University of Texas Medical Branch, Galveston 77550.
Radiology. 1991 Mar;178(3):827-30. doi: 10.1148/radiology.178.3.1994426.
The authors reviewed the ultrasonographic (US) images and medical records of 145 consecutive infants who were seen for evaluation of the upper gastrointestinal tract because of chronic vomiting and/or regurgitation. At US, the antropyloric muscle of each patient was measured in the midlongitudinal plane. On the basis of this measurement, the patients were divided into the following categories: group 1 (1-2 mm; 99 patients), group 2 (greater than or equal to 3 mm; 40 patients), and group 3 (2- less than 3 mm; six patients). Patients in group 1 were considered to have normal antropyloric muscle thickness, those in group 2 had abnormal thickness, and those in group 3 had muscle thickness that was not definitely normal or abnormal. The final clinical diagnoses for all of the infants in the three groups confirmed the authors' initial impressions that antropyloric muscle thickness of less than 2 mm was anatomically normal, muscle measuring 3 mm or greater was abnormal and diagnostic for pyloric stenosis, and muscle from 2 to less than 3 mm was abnormal but not specifically diagnostic for pyloric stenosis. Two of the six patients in group 3 eventually were diagnosed as having pyloric stenosis; thus, the authors believe that only those patients with antropyloric muscle less than 2 mm thick should be considered unequivocably normal.
作者回顾了145例因慢性呕吐和/或反流而接受上消化道评估的连续婴儿的超声（US）图像和病历。在超声检查中，在正中矢状平面测量每位患者的幽门肌。基于该测量结果，将患者分为以下几组：第1组（1 - 2毫米；99例患者）、第2组（大于或等于3毫米；40例患者）和第3组（2 - 小于3毫米；6例患者）。第1组患者被认为幽门肌厚度正常，第2组患者厚度异常，第3组患者的肌肉厚度既不能明确判定为正常也不能判定为异常。三组中所有婴儿的最终临床诊断证实了作者最初的印象，即幽门肌厚度小于2毫米在解剖学上是正常的，测量值为3毫米或更大的肌肉是异常的，可诊断为幽门狭窄，2至小于3毫米的肌肉是异常的，但不能特异性诊断为幽门狭窄。第3组的6例患者中有2例最终被诊断为幽门狭窄；因此，作者认为只有那些幽门肌厚度小于2毫米的患者才能明确被认为是正常的。
