协和医学杂志

2011, v.2(03) 217-221

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下咽及食管异物多排螺旋计算机断层摄影诊断
Diagnosis of Hypopharyngeal and Esophageal Foreign Bodies with Multi-slice Spiral Computed Tomography

张竹花;李烁;苏佰燕;孙昊;孔令燕;王怡宁;薛华丹;祝小莉;高志强;金征宇;
ZHANG Zhu-hua1, LI Shuo1, SU Bai-yan1, SUN Hao1, KONG Ling-yan1, WANG Yi-ning1, XUE Hua-dan1, ZHU Xiao-li2, GAO Zhi-qiang2, JIN Zheng-yu1 1Department of Radiology, 2 Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

摘要(Abstract):

目的探讨下咽及食管异物多排螺旋计算机断层摄影(multi-slice spiral computed tomography,MSCT)影像征像及诊断要点。方法回顾性分析25例经临床证实的急诊下咽及食管异物患者的临床及MSCT图像资料,观察MSCT图像上食管异物的位置、形态,测量异物的最长径以及异物中心距离环状软骨下缘的距离,并观察食管边缘清晰程度、与邻近解剖结构的关系以及有无气肿并发症。结果 MSCT能清晰显示所有患者下咽或食管异物的位置、大小以及与周围解剖结构的关系。25例患者异物位置以食管上段及食管下咽交界处为主。食管异物平均长度为(20·4±7·4)mm(5·4~42·0mm),异物中心距离环状软骨下缘平均约(13·1±17·0)mm(-5·0~30·0mm)。结论 MSCT可从异物位置、大小、与周围解剖结构关系及有无其他并发症多个方面为临床异物取出提供清晰的影像信息。
Objective To explore the radiological findings and diagnostic points of hypopharyngeal and esophageal foreign bodies with multi-slice spiral computed tomography (MSCT). Methods The medical records and CT images of 25 emergency patients with clinically confirmed hypopharyngeal and esophageal foreign bodies were retrospectively analyzed. The location and morphology of the foreign bodies on multi-slice spiral CT images were observed. The longitudinal diameter of the foreign body and the distance from the center of the foreign body to the lower margin of the cricoid cartilage were measured. The margin of the esophagus, the relationship of the foreign body and its neighboring structures, and the existence of pneumoderma and mediastinal emphysema were evaluated. Results The location, size and their relationship with the surrounding anatomical structures of all the hypopharyngeal and esophageal foreign bodies were clearly shown by multi-slice spiral CT. Most of the foreign bodies located in the junction of the hypopharynx and the esophagus and the cervical esophagus. The average length of the foreign bodies was (20.4±7.4) mm (range 5.4 to 42.0mm),while the mean distance from the center of the foreign body to the lower margin of the cricoid cartilage was (13.1±17.0) mm (range -5.0 to 30.0 mm). The foreign bodies of 12 cases located transversely, that of 10 cases located obliquely, while that of 3 cases located vertically. One case showed a poor margin of the esophagus, and one case has pneumoderma and mediastinal emphysema. Conclusions Multi-slice spiral CT can provide clear radiological information for the clinical extraction of foreign bodies by displaying their location, size, and their relationship with the surrounding anatomical structures.

关键词(KeyWords): 下咽;食管;异物;断层摄影术,X线计算机
hypopharynx; esophagus; foreign body; tomography, X-ray computed

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作者(Author): 张竹花;李烁;苏佰燕;孙昊;孔令燕;王怡宁;薛华丹;祝小莉;高志强;金征宇;
ZHANG Zhu-hua1, LI Shuo1, SU Bai-yan1, SUN Hao1, KONG Ling-yan1, WANG Yi-ning1, XUE Hua-dan1, ZHU Xiao-li2, GAO Zhi-qiang2, JIN Zheng-yu1 1Department of Radiology, 2 Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

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