2021 Volume 46 Issue 3 Pages 183-192
Purpose: Pharyngoesophageal diverticula may be imaged by cervical ultrasonography as they tend to be located in the inside or on the outside of the thyroid gland. The purpose of this study is to clarify the ultrasonographic findings of pharyngoesophageal diverticula and their positional relationship to the thyroid gland.
Subjects and Methods: We retrospectively analyzed cervical ultrasound examinations performed at our hospital during an 11-year period, from 200X to 201X, on newly admitted patients with suspicion of thyroid disease. We reviewed ultrasonographic findings such as size, border characteristics, internal structure, blood stream Doppler signals, positional relationship to the thyroid, and swallowing motion.
Results and Discussion: Of the total 152,365 patients involved in this study, 151 patients were diagnosed with a pharyngoesophageal diverticulum (≈0.1%). Ultrasonographic imaging characterized diverticula as 18 mm in size, on the left side in the majority of the patients, with a clear and smooth border, thin hypoechoic layer on the side of the thyroid, lack of border on the back side, many internal hyperechoic spots (linear and disseminated), and a deficiency of internal bloodstream Doppler signals. Based on their positional relationship to the thyroid, these diverticula were classified into three types: (1) buried (majority buried in the thyroid), 78 patients (51.6%); (2) intermediate (half-buried in the thyroid), 62 patients (41.1%); and (3) not buried (push-up the thyroid and not buried), 11 patients (7.3%).
Motion ultrasonography at the time of swallowing saliva showed that saliva did not enter inside, diverticula did not move along with the thyroid, and a thin hypoechoic layer of the diverticula was connected to the mucous membrane of the caudal portion of the esophagus.
Conclusion: Upon performing ultrasonography, the majority of pharyngoesophageal diverticula were found to be buried in the thyroid as a “thyroid nodule.” Examiners who perform cervical or thyroid ultrasonography should pay close attention to this fact.
