目的： 探讨高频超声检查联合动态试验诊断咽食管憩室（pharyngoesophageal diverticulum, PD）的价值。方法： 回顾性分析42例PD患者的常规超声（42例）及依次进行的吞咽口水动态超声（28例）、饮水动态超声（17例）和口服对比剂动态超声（2例）检查所显示的影像学特征,以食管X线吞钡检查结果为金标准进行比较分析。结果： 所有PD患者的病灶均位于甲状腺背侧,其中多数位于左侧（39例,92.9%）,少数位于右侧（3例,7.1%）;42例患者中,根据高频超声检查图像上的低回声壁结构和内部气体强回声诊断为PD者为14例（33.3%）;而依次联合吞咽口水试验、饮水试验、口服对比剂等动态试验,根据阳性表现（液体无回声、气体强回声或对比剂强回声随吞咽进入病灶内部）可将PD诊断率分别提升至59.5%（共25例）、95.2%（共40例）和100%（共42例）。口服对比剂动态试验诊断的2例病灶最大径分别为8.8 mm和24.7 mm。结论： 当发现甲状腺后方肿块时,建议常规行吞咽口水动态超声检查,对7 mm以上病灶建议增加饮水或口服超声对比剂的动态超声检查,以提升PD检出率。

Objective: To evaluate the performance of routine high frequency ultrasound in combination with dynamic tests in diagnosing pharyngoesophageal diverticulum(PD). Methods: A total of 42 cases of PD undergone routine high-frequency ultrasound (42 cases), with successive swallowing saliva test (28 cases), drinking water test (15 cases) or oral contrast-enhanced ultrasound agent (2 cases), were reviewed. The imaging features of ultrasound were compared with findings from esophagus barium swallow examination. Results: All lesions were located in the back of thyroid gland, with 39 cases (92.9%) in the left lobes and 3 cases(7.1%) in the right. Fourteen cases (33.3%) were diagnosed as PD according to the structure of hypoechogenicity wall and internal gas hyperechogenicity presented on the ultrasound imaging. Positive findings of dynamic tests included absence of liquid echogenicity, gas hyperechogenicity or contrast agent hyperechogeni-city entering into the lesions. Sequential execution of swallowing test, drinking water test and oral contrast agent test identified 11 cases (26.2%), 15 cases (35.7%) and 2 cases (4.8%), respectively, increasing the rate of diagnosis from 59.5%（25 cases）, 95.2%（40 cases） to 100% (42 cases). Two cases identified by oral contrast agent test had larger maximum diameter( 8.8 mm and 24.7 mm). Conclusions: For the mass behind the thyroid, high frequency ultrasound in combination with swallowing salivais should be routinely recommended. Drinking water or oral contrast-enhanced ultrasound may facilitate the diagnosis of PD with the diameter of mass greater than 7 mm.