Ahn Dongbin, Lee Gil Joon, Sohn Jin Ho
Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.
J Ultrasound Med. 2018 Nov;37(11):2631-2636. doi: 10.1002/jum.14623. Epub 2018 Aug 12.
Ultrasonography (US) has been considered to have a more limited role in the diagnosis of pyriform sinus fistulas than computed tomography. The aim of this study was to evaluate the US characteristics of pyriform sinus fistulas involving the thyroid gland in an attempt to improve our ability to diagnose this condition using US.
Between 2005 and 2016, 14 patients with pyriform sinus fistulas presenting as suppurative thyroiditis or as thyroid nodules were enrolled in the study. Their US images were reviewed to identify US characteristics indicating the presence of an underlying pyriform sinus fistula and compared with the computed tomographic images.
A hypoechoic tubular lesion across the thyroid gland was identified in 9 patients (64.3%). Hyperechoic foci or echogenic lines were found within the lesion in 10 patients (71.4%). A hypoechoic rim was found at the boundary of the lesion in 7 patients (50.0%). A lesion emerging from the posterolateral aspect of the thyroid cartilage was found in 4 patients (28.6%). Thirteen (92.9%) of the 14 patients had 1 of these 4 findings.
Ultrasonography would be a useful diagnostic modality for indicating the presence of an underlying pyriform sinus fistula in patients with suppurative thyroiditis or a thyroid nodule and can be used as a first-line diagnostic tool to screen for pyriform sinus fistulas.
与计算机断层扫描相比，超声检查（US）在梨状窦瘘的诊断中作用更为有限。本研究旨在评估累及甲状腺的梨状窦瘘的超声特征，以提高我们使用超声诊断这种疾病的能力。
2005年至2016年期间，14例表现为化脓性甲状腺炎或甲状腺结节的梨状窦瘘患者纳入本研究。回顾他们的超声图像以识别提示存在潜在梨状窦瘘的超声特征，并与计算机断层扫描图像进行比较。
9例患者（64.3%）发现甲状腺内有低回声管状病变。10例患者（71.4%）在病变内发现高回声灶或回声线。7例患者（50.0%）在病变边界发现低回声边缘。4例患者（28.6%）发现病变起源于甲状软骨后外侧。14例患者中有13例（92.9%）有这4种表现中的1种。
超声检查对于提示化脓性甲状腺炎或甲状腺结节患者存在潜在梨状窦瘘是一种有用的诊断方法，可作为筛查梨状窦瘘的一线诊断工具。
